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Our analysis compared study protocols for off-label use of gabapentin and the manufacturers' internal research reports with the published reports of study findings. The results of this analysis 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 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). 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. Off-label prescribing does not necessarily signify that the medication is being used improperly, and in some cases, reliable research might validate its use. Nonetheless, prescribing gabapentin for off-label use might also result in negative consequences, including adverse drug effects, liability concerns, and a lack of reimbursement due to the 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. Vedula SS, Bero L, Scherer RW, et al. Outcome reporting in industry-sponsored trials of gabapentin for off-label use. N Engl J Med. 2009;361(20):1963-1971. Goodman CW, Brett AS. A clinical 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 Off-label uses for gabapentin. Doctors often prescribe gabapentin off-label to treat conditions such as: pain from diabetic neuropathy, which is numbness or uncomfortable tingling caused by nerve damage from diabetes; nerve pain in the neck and back from conditions such as sciatica, a painful compression of the sciatic nerve 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. OBJECTIVES: (1) Describe the relevance of off-label use of gabapentin to man-aged care pharmacy; (2) summarize recent FDA warnings and media reports related to off-label gabapentin use; (3) review medical information pertaining to the off-label use of gabapentin; (4) outline alternatives to off-label use of 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. In December 1993, the US Food and Drug Administration (FDA) granted approval for gabapentin, under the brand name Neurontin, for adjunctive therapy of partial seizures. Subsequently, the FDA approved gabapentin in 2000 for treatment of partial seizures in children aged 3 years or older and in 2002 This study examined off-label use of gabapentin for psychiatric indications and its concomitant use with CNS-D prescription drugs in a nationally representative sample of ambulatory care office visits. Less than 1% of outpatient gabapentin use was for FDA-approved indications. Observations: This report summarizes the limited published evidence to support off-label gabapentinoid uses, describes clinical cases in which off-label use is problematic, and notes how review articles and guidelines tend to overstate gabapentinoid effectiveness. All three are taking the non-opioid pain drug for off-label uses. The only conditions for which gabapentin has been approved for adult use by the Food and Drug Administration are epileptic In this nationally representative sample, <1% of outpatient gabapentin use was for approved indications. High concomitant use of CNS-D drugs and off-label gabapentin for psychiatric diagnoses underlines the need for improved communication about safety. 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. 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. 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.
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