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Choosing gabapentin and pregabalin: These drugs are widely used off-label as an alternative to benzodiazepines for anxiety disorders. The speed of their onset of action has not been clearly established, but many clinicians have the impression that it is often within a few days, much shorter than that for antidepressants. Perhaps one of the more promising off-label uses for Gabapentin is for the treatment of anxiety disorders. There is mounting evidence that Gabapentin may be an effective intervention for various types of anxiety including: generalized anxiety disorder, social anxiety disorder, and panic disorder. Gabapentin has been approved by the United States (US) Food and Drug Administration (FDA) for postherpetic neuralgia and as adjunctive therapy for focal seizures. 1 However, a recent analysis of US physician office-based prescription practices between 2011 and 2016 found that less than one percent of gabapentin prescriptions are for such indications. 2 In 2020, gabapentin was reported to be Off-label gabapentin (Neurontin) got a bad rep when it missed the mark in bipolar disorder, but there may be something worth salvaging in this drug. Here, we weigh its pros and cons for anxiety, substance use disorders, sleep, pain, and hot flashes, and compare it to its underutilized cousin, pregabalin (Lyrica). In addition to being used to treat pain, gabapentin is used off label to treat anxiety, alcohol use disorder (AUD), alcohol withdrawal, depression, substance use disorders (SUDs), sleep problems, and more. However, the data to support these off-label uses of gabapentin are mixed, especially for long-term use. While Gabapentin is FDA-approved for partial seizures and postherpetic neuralgia, its off-label uses are more extensive, especially in psychiatry. Gabapentin for anxiety disorders is notable, with doses between 900 and 3,600 milligrams per day showing effectiveness in reducing symptoms. Gabapentin has also been prescribed off-label for anxiety despite a lack of research evidence supporting such use . It was found to be efficacious in a small ( N = 69) randomized, double-blind, placebo-controlled study in SAD ( 62 ). Gabapentin is another antiepileptic medication, approved for partial seizures and nerve pain. It’s frequently used off-label to treat anxiety disorders and post-traumatic stress, as it Key takeaways: Gabapentin (Neurontin) is FDA approved to treat seizure disorder and nerve pain from shingles. But it’s also used off-label to treat many other conditions, including anxiety, nerve pain from diabetes, and hot flashes. While there’s limited evidence that gabapentin helps with anxiety, some doctors may prescribe it off-label to treat the mental health condition. This use of gabapentin for the treatment of anxiety is referred to as an off-label use, meaning there is limited data on its effectiveness to treat anxiety. Other off-label uses include treating alcohol withdrawal for alcohol use disorder and hot flashes associated with menopause. Gabapentin is a medication that can be used off-label to treat anxiety. Learn how it works, its benefits, and considerations for taking it for anxiety. However, their off-label use for anxiety disorders, such as generalized anxiety disorder (GAD) and social anxiety disorder (SAD), is on the rise. Clinical trials show that about 50% of GAD patients report improved symptoms when treated with gabapentin. Gabapentin is widely used in the United States for a number of off-label indications, often as an alternative to opioid therapy. Increasing evidence has emerged suggesting that gabapentin may not be as benign as once thought and may be associated with substance abuse in concert with opioids. Find out more about gabapentin and pregabalin and how these anticonvulsant medications are showing promise as off-label treatments for anxiety disorders. Objective: Gabapentin is widely prescribed off label in medical practice, including psychiatry. The U.S. Food and Drug Administration (FDA) warned of risks associated with gabapentin combined with central nervous system depressant (CNS-D) drugs, which are commonly prescribed in psychiatric treatment. This study examined off-label outpatient gabapentin use for psychiatric indications and
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