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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. While there’s limited evidence that gabapentin helps with anxiety, some doctors may prescribe it off-label to treat the mental health condition. Gabapentin’s off-label use in PTSD management is gaining recognition due to its potential to reduce anxiety and improve sleep, two key symptoms of PTSD. Clinical Observations: A study published in the Journal of Traumatic Stress suggested that Gabapentin could be a promising adjunct therapy for PTSD, particularly when used in combination with Gabapentin is seen as a new possibility for treating anxiety, especially when usual treatments don’t work. Traditional treatments use benzodiazepines and antidepressants which work in different ways. It’s very important to know the side effects when looking at Gabapentin versus traditional options. off-label experimentation with gabapentin commenced for neuropathic pain, bipolar disorder, and migraine prophylaxis (6). The sustained upward trend in off-label prescribing of gabapentin is concerning, considering the minimal high-quality evidence for many off-label uses. Recent attention to off-label use of gabapentin is largely 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 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 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. Off-Label Uses. Gabapentin is used off-label use for fibromyalgia, bipolar disorder, anxiety disorders, resistant depressants, mood disorders, irritable bowel syndrome, alcohol withdrawal, postoperative analgesia, migraine prophylaxis, interstitial cystitis, painful diabetic neuropathy, social phobia, generalized tonic-clonic seizures, pruritus Evidence supports gabapentin as a treatment for alcohol withdrawal and alcohol use disorder. There is sufficient evidence to consider gabapentin as a third-line treatment for social anxiety disorder and severe panic disorder. In today’s video, we explore the off-label uses of Gabapentin, also known as Neurontin. While Gabapentin is FDA-approved for partial seizures and postherpetic neuralgia, its off-label uses are more extensive, especially in psychiatry. Gabapentin was originally approved by the US Food and Drug Administration (FDA) for the treatment of partial seizures in 1993, 1, 2 with subsequent approval for postherpetic neuralgia in 2002. 3 – 5 Within a decade of initial FDA approval, gabapentin’s second most common use became off-label prescription for psychiatric disorders. 6 If you think gabapentin may help you, discuss this drug with your physician. Realize that off-label use is no guarantee for success, but that decision is for your doctor to make. Be aware that gabapentin is not a harmless drug, and its side effects can be worrisome. Allergic reactions with any drug are emergencies. 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 sold under the brand names Horizant®, Gralise 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. 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. 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. Concomitant use of gabapentin and CNS-D drugs was similar for the total sample of gabapentin visits and for the off-label gabapentin visits . For the off-label gabapentin visits, only 3.6% of visits listed gabapentin as the only prescription medication. Most off-label gabapentin visits (90.6%) listed two or more prescription medications. In addition to medicines with FDA indications for anxiety, such as benzodiazepines and some antidepressants, a number of drugs are frequently prescribed off-label. Among these are gabapentin and the related compound pregabalin, collectively known as gabapentinoids. Pregabalin sees more use for anxiety in Europe, where it has regulatory approval in generalized anxiety disorder, while US psychiatrists lean toward gabapentin. The evidence is clearly in pregabalin’s favor, but gabapentin does have a tolerability advantage, with lower rates of weight gain and ataxia (Shaheen A et al, Pak J Med Sci 2019;35(6
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