In addition to these FDA-approved uses, doctors sometimes prescribe gabapentin off-label. Off-label use means there is some evidence to show that a drug may be medically appropriate to treat conditions other than those for which it was approved. Gabapentin is sold under the brand name Neurontin and is available as a generic product as well. The authors note that Pfizer was previously penalized for deceptive marketing practices promoting off-label uses for both gabapentin and pregabalin, and they suggest that these practices may have 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. 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: It is estimated that approximately 9/10 prescriptions for Gabapentin are “off-label” or for conditions that the drug isn’t approved to treat. Off-label prescriptions have a reduce chance of actually working for the treatment of anxiety. The rise in gabapentin prescribing is multifactorial but thought to be due in part to efforts by the pharmaceutical industry to promote the use of the medication for off-label uses. (In 2004, the manufacturer of Neurontin, Pfizer, pleaded guilty to multiple counts of illegally promoting the off-label use of gabapentin, resulting in nearly $430 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. 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. The rise in gabapentin prescribing is multifactorial but thought to be due in part to efforts by the pharmaceutical industry to promote the use of the medication for off-label uses. (In 2004, the manufacturer of Neurontin, Pfizer, pleaded guilty to multiple counts of illegally promoting the off-label use of gabapentin, resulting in nearly $430 We selected gabapentin (Neurontin), a medication reported to be widely used off label, as a specific example to explore specialist physicians' experiences with off-label prescribing. For gabapentin, the only pain-related indication approved by the US Food and Drug Administration (FDA) is postherpetic neuralgia. For pregabalin, FDA-approved indications related to pain are limited to postherpetic neuralgia, neuropathic pain associated with diabetic neuropathy or spinal cord injury, and fibromyalgia. 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). Gabapentin’s off-label uses—meaning prescribing gabapentin for a problem not on the FDA approval list for this medication—that physicians are finding include: Alcohol withdrawal; Anxiety; Cocaine withdrawal; Fibromyalgia; Headaches; Hiccups; Hot flashes; Hyperhidrosis; Insomnia; Migraines; Mood disorders; Pain syndromes; Peripheral 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. “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 Despite these limited indications, gabapentin and pregabalin are widely prescribed off-label for various other pain syndromes. Such use is growing, possibly because clinicians are searching increasingly for alternatives to opioids. 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. Known off-label uses where doctors prescribe gabapentin include as a treatment for hot flashes, restless leg syndrome, mood disorders, anxiety, and to diminish nerve pain related to diabetes or 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. 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. Gabapentin may be effective for anxiety, but it’s usually not a first-choice medication for this use.
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