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Can You Use Gabapentin For Anxiety?

Although gabapentin is classified as an anticonvulsant drug that is primarily prescribed to treat epileptic seizures and nerve pain following an episode of shingles, research has shown that it may also be an effective off-brand treatment for people suffering from anxiety. In fact, studies indicate that people with generalized anxiety disorder (GAD) have shown a decrease in a number of symptoms, including less irritability/depressive symptoms, a lowered tendency to use or abuse alcohol as a form of self-medication, an improvement in phobic avoidance (i.e., enabling GAD sufferers to go out in public more frequently while minimizing the instance of subsequent panic attacks), and a reduction in anxiety with regard to anticipating future events. While Neurontin is the most common brand name for gabapentin, other forms (such as Horizant and Gralise) may be prescribed depending on the specific condition it is being used to treat. Gabapentin has also been shown to help people with insomnia, as difficulty falling or staying asleep is another symptom of chronic anxiety. 

Gabapentin: A Brief History

Over the last several decades, there have been various studies researching the efficacy of gabapentin in the treatment of anxiety disorders. As of December 30, 1993, gabapentin received final approval by the FDA for marketing in the United States. While it is only marketed as an anticonvulsant drug, it has also been used to treat Restless Legs Syndrome (RLS), tremors, hot flashes, chronic pain issues, and a broad array of psychiatric disorders. In 1998, a review in The American Journal of Psychiatry reviewed several case studies, and the findings indicated that gabapentin may be useful in two distinctive ways: either as an additive medication for individuals suffering with anxiety disorders, or as a standalone treatment for specific anxiety disorders (most commonly panic disorder and generalized anxiety disorder). While case studies do not furnish enough empirical data for the usage of any medication, they can encourage further research. In the case of gabapentin, the effectiveness of this drug is still being studied to determine how it may benefit individuals who suffer from generalized anxiety disorder (GAD).

How Long Will It Take For Gabapentin To Relieve Anxiety Symptoms?

Depending on the age of the patient, gabapentin’s effectiveness – and how long it will take to work – may vary a great deal. There are numerous factors to consider, including the severity of the individual’s anxiety, as well as the type of anxiety they are being treated for. On average, the timeline for the drug’s efficacy is about 3 weeks, but the patient may experience the benefits of the medication sooner or later than that time frame. Therefore, it’s important to keep in mind that while gabapentin may be a useful medication for some individuals, it may not be effective for you. In the event that you are considering gabapentin as a treatment option for yourself or a family member, speak with your physician and decide together if this prescription drug will be the best and most effective course of therapy for anxiety.

What Dosage Should I Take For Gabapentin?

If you or a loved one are prescribed gabapentin to treat anxiety, your physician will determine the correct dosage needed. In addition, most doctors will typically start off treatment with a low dosage, and gradually increase the dosage until the physician determines it is at the right level. Gabapentin tablets are available in 100, 300, 400, 600, and 800 mg, while gabapentin capsules are available in 100, 300 and 400 mg doses. No matter what your dosage amount, never change your dosage or stop taking medications without the express consent of your physician, as doing so may result in serious harm.

Gabapentin And Off-Label Usage: What Are The Benefits?

Because it’s a fairly safe medication to administer, gabapentin has grown quite popular with physicians for a variety of off-label treatments. Some of the benefits include limited side effects, as well as very few dangerous reported interactions when taken with other medications. Whereas other medicines might pose serious side effects or present a possible medical issue, gabapentin is often used instead because it replicates the actions of the gamma aminobutyric acid (GABA), a naturally-occurring amino acid that works as a neurotransmitter in the human brain.

GABA is referred to as an inhibitory neurotransmitter, because it blocks or inhibits particular brain signals while decreasing activity in your nervous system. When GABA attaches to a protein in your brain (known as a GABA receptor), it produces a calming effect. In turn, this chemical reaction can ease feelings of stress, anxiety and even fear. It may also help to prevent seizures. However, in some instances, individuals with specific medical conditions may have lower levels of GABA; some of these conditions may include:

In order to manage the symptoms from these various conditions and disorders, your physician may prescribe gabapentin. Since it mimics the actions that GABA has on brain function, it’s prescribed by doctors in numerous situations where other medications might have serious side-effects or result in drug dependency. For example, benzodiazepines and other selective serotonin reuptake inhibitors are frequently used to treat certain types of anxiety disorders. However, gabapentin has been shown to be a safer alternative (used as an additive medication or a standalone treatment), since it has a much lower risk of abuse than benzodiazepines, which are highly addictive.

In addition to anxiety, gabapentin is often prescribed for other off-label uses, including:

  • Gabapentin for pain management: There has been some clinical research that shows gabapentin may provide satisfactory levels of pain relief to individuals who suffer from chronic pain as a result of peripheral diabetic neuropathy or postherpetic neuralgia (or pain following a bout of shingles). Based on the studies, approximately 50% of patients tested reported an improvement in sleep patterns, a reduction in fatigue and depression, and an overall improvement in quality of life. If you suffer from either of these conditions, your physician may prescribe a short trial to determine if this course of treatment is right for you.
  • Gabapentin for RLS: An acronym for Restless Legs Syndrome, gabapentin has also been found to be a useful and effective treatment for RLS. According to research as presented at the 28th Annual Meeting of the Associated Professional Sleep Societies, gabapentin (sold under the trade name Horizant or Neurontin) has been shown to improve sleep, daytime function, and symptoms of RLS. It may be particularly effective if the symptoms are perceived as less intense yet painful. Furthermore, the medication may be of added benefit for people with a history of chronic pain or peripheral neuropathy. It may also be useful in treating RLS in the context of other neurological disorders, such as dementia or Parkinson’s disease.
  • Gabapentin for withdrawal: Another common off-label usage of gabapentin includes assisting people who are in recovery from abuse of alcohol or several different types of drugs. Gabapentin has been shown as an effective form of treatment therapy for individuals going through alcohol withdrawal symptoms. It’s also been used to treat withdrawal side-effects from drugs including opiates, cannabis, and benzodiazepines (for seizure control), as well as aiding in the reduction of withdrawal symptoms such as anxiety, cravings, issues with cognition, and other physical symptoms of substance withdrawal syndrome.

What Are The Side Effects Of Gabapentin?

Just as in the case of any medication, gabapentin has several side effects individuals should be aware of. However, this medication does not affect every person the same way; therefore the side-effects you may experience are relative to your personal reaction to gabapentin.

Some of the side effects of gabapentin may include (but are not limited to):

  • Continuous, back-and-forth, rolling or uncontrolled/unusual eye movements
  • Difficulty speaking
  • Dizziness
  • Double vision
  • Feeling extremely sleepy or tired
  • Fluid retention
  • Jerky movements
  • Loss of control of bodily movements
  • Nausea
  • Tremors
  • Unsteadiness or clumsiness
  • Vomiting

In the event that you or a loved one (including your child or a person under your care) experience any of the above symptoms, be sure to contact your physician immediately. If you suspect an allergic reaction, go to your nearest emergency room or dial 911 for help. Allergic reaction symptoms may include swelling of the face, tongue, lips or throat, and may also be indicated by hives or difficulty breathing.

For a more comprehensive list of side-effects (including side-effects commonly observed in children), speak with your physician during your doctor’s appointment to go over possible side effects if you or a family member are prescribed gabapentin.

 

Sources Cited:

1)      “Using Gabapentin For Anxiety.” Clarity Clinic (claritychi.com), May 1, 2020, https://claritychi.com/using-gabapentin-for-anxiety/. Accessed June 2, 2020.

2)      “Gabapentin Tablet, Extended Release 24 Hr.” WebMD.com, (no publish date), https://www.webmd.com/drugs/2/drug-14208-1430/gabapentin-oral/gabapentin-sustained-release-oral/details. Accessed June 2, 2020.

3)      Nuss, Phillippe; MD. “Anxiety disorders and GABA neurotransmission: a disturbance of modulation.” NCBI (National Center for Biotechnology Information | U.S. National Library of Medicine / ncbi.lm.nih.gov), January 17, 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303399/. Accessed June 2, 2020.

4)      Snodgrass, S. R. “GABA and Epilepsy: Their Complex Relationship and the Evolution of Our Understanding.” NCBI (National Center for Biotechnology Information | U.S. National Library of Medicine / ncbi.lm.nih.gov), January 1992, https://pubmed.ncbi.nlm.nih.gov/1313057/. Accessed June 2, 2020.

5)      Westphalen, Dena; PharmD. “What Does Gamma Aminobutyric Acid (GABA) Do?” Healthline.com, March 7, 2019, https://www.healthline.com/health/gamma-aminobutyric-acid#effectiveness. Accessed June 2, 2020.

6)      Peters, Brandon; MD. “How Gabapentin Can Treat Restless Legs Syndrome.” Verywellhealth.com, February 6, 2020, https://www.verywellhealth.com/gabapentin-can-treat-rls-symptoms-3015183. Accessed June 2, 2020.

7)      Wiffen PJ; Derry S; Bell R; Rice ASC; Tölle T; Phillips T; Moore R. “Gabapentin for chronic neuropathic pain in adults.” Cochrane.org, June 9, 2017, https://www.cochrane.org/CD007938/SYMPT_gabapentin-chronic-neuropathic-pain-adults#:~:text=Gabapentin%20at%20doses%20of%201800,neuropathic%20pain%20is%20very%20limited.. Accessed June 2, 2020.

8)      Cagliostro, Dina; PhD. “Gabapentin for Depression, Mania and Anxiety.” Psycom.net, (no publish date), https://www.psycom.net/depression.central.gabapentin.html. Accessed June 2, 2020.