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Gabapentin For Anxiety – Very Popular Off-Label Usage

Gabapentin is the generic name for a common anticonvulsant, anti-epileptic prescription drug. It is sold in the United States under brand names including;

  • Neurontin
  • Gralise
  • Horizant

It was first approved for use by the FDA is 1993 as a anti-seizure medication in conjunction with other anti-convulsants.

  • Pfizer is the maker of both Neurontin and its generic Gabapentin.

It has paid at least $945 million to resolve a number of civil and criminal lawsuits related to illegal marketing and off-label distribution of Neurontin. These costly lawsuits included promoting the use of for anxiety, migraine headaches, and pain.


According to Calm Clinic: “There are several drugs that may be prescribed for anxiety that are not commonly in use. One such drug is Neurontin. Neurontin – also known as Gabapentin – is a drug that is rarely prescribed to those whose sole mental health issue is anxiety. But it is occasionally prescribed to those that are struggling with bipolar disorder as a way of relieving anxiety symptoms.”

Gabapentin is a synthesized form of the neurotransmitter GABA, a chemical messenger who is a “natural function is to reduce the activity of the neurons to which it binds”. People who suffer from generalized anxiety disorder (GAD), social anxiety disorder, panic attacks, and other forms of anxiety are widely believed to have abnormally high neural activity, which is why some doctors prescribe it for anxiety.

GABA binds to GABA receptors within the brain, resulting in a slowing of the activity within these over-excited neurons, which can lead to a reduction in the frequency and severity of symptoms of anxiety among some patients.

  • It’s important to note using it for anxiety is an ‘off-label’ use of this drug.

The FDA does not actually endorse the use of this drug for anxiety. As a result, there “are no randomized controlled trials on the effectiveness of this medication in generalized anxiety disorder (GAD)”.

  • There are very few studies focused on gabapentin as a treatment for any other types of anxiety.
  • Despite the lack of clinical studies, gabapentin use among people with anxiety and other mental health issues such as depression is relatively common.

Off-Label Use

Despite the fact that gabapentin was initially designed to help control seizures, in the U.S. it is often prescribed as an off-label medication, meaning it’s being used for conditions other than seizures.

  • It is estimated that nearly 90% of Gabapentin prescriptions are for off-label uses

Gabapentin is one of two prescription medications used in the Prometa treatment protocol for methamphetamine, cocaine, and alcohol addiction. Researchers have concluded:

  • “It also helps those addicted to prescribed pain medication and reduces withdrawal syndromes”.

For Nerve Pain

Gabapentin is one of a number of anti-seizure medications that is often prescribed to patients suffering from neuropathic pain, otherwise known as nerve pain. Gabapentin helps to suppress excessive neuron activity associated with burning, shooting, or stabbing nerve pain in some patients, leading to relief from the pain while improving life quality factors such as the ability to achieve a restful night’s sleep, engage in social activities, and perform day-to-day tasks.

Side Effects

Gabapentin (Neurontin) is known to cause a variety of side effects, including:

  • Skin rash and/or hives
  • Shortness of breath
  • Swollen glands
  • Swelling throughout the lips, throat, tongue, and face
  • Extreme fatigue
  • Muscle weakness and a lack of co-ordination
  • Unexplained muscle pain
  • Abnormal bleeding and bruising

Researchers have demonstrated that some patients suffering from diabetic neuropathy, fibromyalgia, nerve pain from shingles, and post-operative nerve pain (common among amputees) can achieve “good levels of pain relief” from 1800 mg to 3600 mg of gabapentin daily, although in one study, less than half of the participants experienced “worthwhile pain relief” from gabapentin.

Under a physicians care, some patients, who use this drug for anxiety, may begin with a 300 mg dose taken in the evening. Then the dose may be slowly increased by the prescribing physician until optimal results are achieved.


Sudden discontinuation of gabapentin has been linked to serious problems, such as:

  • Suicidal thoughts
  • Suicide attempts
  • An escalation or sudden onset of anxiety, depression, and/or panic attacks
  • Impulsive, aggressive behavior
  • Insomnia
  • Mania, including hyperactivity

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