Gabapentin isn’t the main treatment option for anxiety, but it can be an effective alternative when other medications haven’t worked.

Doctors may prescribe gabapentin to treat various health conditions, including mental health conditions.

First discovered in the 1970s, doctors originally prescribed gabapentin as a muscle relaxer. The drug later showed promise in treating seizure disorders and nerve pain.

The Food and Drug Administration (FDA) hasn’t yet approved the use of gabapentin to treat anxiety. Still, some evidence suggests it may help with symptoms.

Gabapentin is one of the most widely prescribed medications. The generic drug is also sold under the brand names Neurontin or Gralise.

Currently, the FDA approves gabapentin to treat:

Doctors may also prescribe the drug off-label for :

Off-label prescriptions are prescriptions for approved medications that aren’t approved for the specific condition you have.

How does gabapentin work?

Gabapentin helps manage shingles-related pain by changing the way you sense the ache.

As an anticonvulsant drug for seizures, gabapentin decreases any unusual excitement within the brain that can lead to seizure activity.

According to a 2015 systematic review, researchers aren’t clear on how gabapentin treats psychiatric disorders, but it appears the drug works similarly to other anti-anxiety medications.

Evidence also suggests gabapentin is more effective in reducing the symptoms of alcohol withdrawal and certain types of anxiety than conditions like bipolar disorder, panic disorder, or panic attacks.

However, more research is needed to make any definitive conclusions.

Although evidence is limited, some studies show gabapentin can help with anxiety symptoms.

One 2020 review suggests gabapentin may help with different types of situational anxiety, including:

But there’s little evidence that gabapentin can help with symptoms of generalized anxiety disorder (GAD).

Gabapentin misuse

According to a 2020 review, about 1 to 10% of people may experience a sense of euphoria when taking gabapentin, which may increase the likelihood of misuse. And data suggest that 40-65% of people taking gabapentin misuse the medication.

You have a higher chance of misusing the drug if you have:

Substance use disorders affect many people, but recovery is possible, and help is available. If you want to learn more and find support, consider reaching out to SAMHSA’s National Helpline at 800-662-4357 and reading Psych Central’s substance use disorder resources.

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Because doctors prescribe gabapentin off-label for anxiety, there’s no specific dosage for treating anxiety symptoms.

Your dosage will depend on your:

  • age
  • weight
  • health history

A potential starting dose is 300 milligrams (mg) once daily. Your doctor may recommend slowly increasing the dosage to 4,800 mg daily.

Some people feel the drug’s effects within a week, but it can take up to a month in some cases.

You may experience side effects while taking gabapentin, including:

  • drowsiness
  • dizziness
  • headache
  • tremors
  • nausea
  • vomiting
  • diarrhea
  • swelling

While uncommon, gabapentin can also cause serious side effects like:

  • anaphylaxis
  • seizures
  • withdrawal
  • liver and kidney damage

Consider talking with your doctor if you experience signs of liver or kidney damage like problems urinating, unexpected bleeding, or yellowing of your skin.

If you experience a rash, itching, or trouble breathing, you may be having an allergic reaction. Seek emergency medical attention.

Discontinuing gabapentin

It’s important to continue taking gabapentin even if you start to feel better.

If you’re thinking of stopping gabapentin, it’s a good idea to talk with your doctor about tapering off. Stopping suddenly can increase your chances of experiencing seizures. Some people can also experience withdrawal symptoms when stopping this medication.

These may include:

  • anxiety
  • trouble sleeping
  • pain
  • excess sweating

You and a doctor can make a plan for safely and gradually decreasing your dosage over time.

There’s not enough research to make conclusions about gabapentin’s effectiveness for anxiety.

While gabapentin doesn’t have FDA approval for treating anxiety, alprazolam (Xanax) is FDA-approved to treat GAD.

According to one 2014 study that compared the effectiveness of Xanax and gabapentin for pre-surgery anxiety, Xanax is a better option for relieving immediate stress and worry.

And a 2020 review of studies points out that there’s limited evidence for gabapentin as an effective treatment for anxiety.

It may be helpful to talk with your doctor to decide which treatment option is best for your needs.

While there’s limited evidence that gabapentin helps with anxiety, some doctors may prescribe it off-label to treat the mental health condition. Even though it’s not FDA-approved, you may find it can help with your anxiety.

It’s a good idea to discuss anxiety treatment options with your doctor. And remember that what works for someone else might not work for you.

Finding an effective treatment might involve some trial and error. You may also find it helpful to include other strategies in your treatment plan, including therapy, meditation, and support groups.

Managing your anxiety can be challenging, but it is possible to live a happy life with less worry and stress. Help is out there.