Gabapentin is an anticonvulsant prescription drug that goes by several brand names including, Neurontin, Gralise, Gabarone, and Fanatrex.
It was approved by the FDA in December 1993 for the following main uses.
- Controlling certain types of seizures in people who have epilepsy
- Relieving nerve pain (think: burning, stabbing, or aches) from shingles
- Calming restless legs syndrome
But since it’s been available, gabapentin has also been used off-label in psychiatry to treat patients with treatment-resistant mood and anxiety disorders as well as alcohol-withdrawal and post-traumatic stress. It works by decreasing abnormal excitement in the brain for seizures and changing the way the body senses pain for nerve pain. Researchers don’t know exactly how it works for psychiatric conditions. (*Note: Some states have recently classified gabapentin as a controlled substance due to the potential for it to be abused and contribute to death from overdose.)
Treatment with Gabapentin: Important Things to Know Before Taking Gabapentin
Before you start gabapentin therapy, you should have a thorough medical exam to rule out any medical issues. This includes any blood or urine tests. Medical evaluations are important as gabapentin can induce hormonal imbalances. Like any other drug, you should not take gabapentin if you’re allergic to it.
There are side effects—more on that in a minute. But a few of the most important things your doctor will want to find out before prescribing gabapentin is if you have or have had any of the following:
- Drug or alcohol addiction
- Kidney problems (or if you’re on dialysis)
- Liver or heart disease
- Lung disease (see the warning above on respiratory issues)
- Mood disorders, depression or bipolar; or if you’ve ever thought about suicide or attempted suicide
- Seizures (unless, of course, you’re taking it for seizures)
You should also know that not enough studies have been done to understand the exact risks of gabapentin if you’re pregnant or breastfeeding.
How Gabapentin Is Used to Treat Anxiety Mood Disorders Like Depression
Gabapentin isn’t usually used to treat anxiety alone. More often, it’s given to ease anxiety symptoms for someone who also has depression or bipolar disorder. (Anxiety is common comorbid with depression and bipolar.) The reason is that it may not be effective for just anxiety. A close look comparing seven different clinical trials on how successful gabapentin is for anxiety shows that gabapentin may be better than a placebo to treat generalized anxiety disorder (GAD), but not much better. Results may be slightly more promising for social anxiety disorder.
The clinical trials for treating depression with gabapentin are also pretty lackluster. To date, there are no scientific studies showing it’s effective—either on its own or as part of some other therapy. Still, there is some anecdotal evidence that it’s helpful, especially with patients who don’t seem to improve with more standard antidepressants.
How Gabapentin Is Used to Treat Mixed Bipolar States
More specifically, can it prevent future episodes of mania and depression? Right now, there is no good evidence that gabapentin can be used for treating people with bipolar disorder. High-quality, randomized controlled studies found that gabapentin was not effective.1,2
Gabapentin and Alcohol Use Disorder
Gabapentin may be helpful in treating alcohol use disorder and withdrawal. Between 2004 and 2010, The Veterans Affairs Department conducted a double-blind, placebo-controlled, randomized dose-ranging trial of 150 men and women over 18, struggling with alcohol dependence.3 The results of the study showed that gabapentin (particularly the 1800 mg dosage) was effective in safely treating alcohol dependence and relapse-related symptoms including insomnia, dysphoria, and cravings.