Gabapentin for Anxiety: What You Need to Know

Gabapentin for Anxiety: What You Need to Know

Learn how gabapentin works and why you may be prescribed this medication for anxiety. Insights from our psychiatrists.

Reviewed by:
Sophia Monsour, DO
|
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September 19, 2023
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Key takeaways

Whether you’re already taking gabapentin for an anxiety disorder or are curious if you might benefit from it, you may be wondering how effective it is, how it works, and if there are side effects.  

Here we’ll cover everything you need to know about gabapentin for anxiety.  

What is Gabapentin?

Gabapentin is a prescription drug or medication that is FDA-approved to treat nerve pain and seizure disorders. It also has other uses—including treating anxiety disorders—though it has not been FDA-approved to be used for this purpose. This use of gabapentin for the treatment of anxiety is referred to as an off-label use, meaning there is limited data on its effectiveness to treat anxiety. Other off-label uses include treating alcohol withdrawal for alcohol use disorder and hot flashes associated with menopause.  

Gabapentin is sold under the brand names Horizant®, Gralise® and Neurontin®.

Because there is limited research on how effective gabapentin is at reducing anxiety symptoms, it’s not typically the first medication a licensed physician will recommend for treating anxiety.

Antidepressant medications like SSRIs and SNRIs are most likely to be prescribed first due to their effectiveness and safety. If these other treatment options aren’t successful or appropriate, a doctor may prescribe gabapentin.  

How does Gabapentin work?

Gabapentin works by mimicking a neurotransmitter in the brain called GABA. GABA has a calming effect on the brain and impaired functioning of GABA has been linked to various mental health conditions such as panic disorder and depression.  

It’s important to note that the medication gabapentin isn’t a synthetic or lab-made form of GABA. It works by mimicking GABA. It slows down or stops messages from being sent between nerve cells—this results in a reduction of pain associated with nerve damage as well as the prevention of seizures.  

While it's true that GABA plays a role in anxiety, anxiety is complex, and researchers are still trying to figure out how and if gabapentin might work to ease symptoms of moderate or severe anxiety. Based on some promising studies, some scientists and doctors agree that it may be helpful for treating social anxiety disorder and severe panic disorder (frequent panic attacks) in people who don’t respond to other treatments.

To learn more about the different type of anxiety disorders, check out: An Overview of the 5 Major Types of Anxiety Disorders


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Taking Gabapentin for Anxiety

If you are prescribed gabapentin for anxiety —like any medication—it's important to take it exactly as directed. The dose you are prescribed will depend on your response to the medication and your specific needs. You’ll likely start on a low dose and then your provider will work with you to increase your dose based on your response and symptoms. If you aren’t responding to treatment for example, your doctor may suggest a higher dose or a different medication.  

If you’re living with anxiety, you’re likely eager to manage your symptoms, especially if you’ve tried various treatment options. Keep in mind that finding the right medication can take time and while it can be difficult, it’s important to remain patient with the process. Not taking your medication as directed can lead to increased side effects and safety issues.  

Your prescribing physician should walk you through the specific instructions on how to take your medication, the side effects to look out for, and set expectations for how long the medication will take to help reduce your anxiety symptoms.    

Potential side effects of Gabapentin

Like all medications, gabapentin can come with side effects. The side effects are usually mild and go away as your body adjusts to the medication. If you experience mild side effects, be sure to continue taking your medication as directed. Stopping your medication suddenly can lead to withdrawal symptoms.  

Some common side effects include:  

  • Drowsiness or dizziness
  • Nausea
  • Vomiting
  • Diarrhea
  • Mood changes
  • Swelling in the arms and legs
  • Blurred vision  
  • Dry mouth  
  • Erectile dysfunction
  • Weight gain  
  • Memory problems
  • Headaches  
  • Getting sick more than usual  

If you experience any side effects, be sure to report them to your doctor. They may suggest adjusting the dose of your medication or trying a different option.  

Some rare but serious side effects can also occur. Reading about side effects can be anxiety-inducing so if you are concerned about the side effects of a medication, be sure to chat with your doctor. Your doctor is there to help you weigh the pros and cons of taking medication and you should always feel like the benefits of taking medication outweigh any risks. That said, some serious side effects include:

  • Thoughts of harming or killing yourself  
  • A high temperature
  • Swollen glands  
  • Yellowing of eyes or skin
  • Unusual bleeding or bruising  
  • Severe fatigue or weakness  
  • Unexpected muscle pain or muscle weakness, with or without a rash
  • Hallucinations
  • Long-lasting stomach pain or vomiting

If you experience any of these symptoms call your healthcare provider or 911 right away.  

How long does it take for gabapentin to work for anxiety?

It may take some time to find a dose of gabapentin that works for you, but generally, once you’ve settled on the right dose, you may begin to see improvements in around 3 weeks or less. Everyone will respond differently to medication and it may take more or less time to see a change in your anxiety levels. Try and remain patient with the process and always take your medication as directed by your doctor.  

Gabapentin alternatives

Gabapentin is one option for treating anxiety but it’s not the only option. Depending on your needs and medical history your doctor may recommend a different type of medication. Here are some other medications commonly used to treat anxiety:  

  • Antidepressants, including SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors). These work by increasing the availability of certain neurotransmitters (chemical messengers) in the brain that affect your mood. Balancing the levels of these chemicals can result in a decrease in anxiety symptoms. It may take a few weeks to see the full effects of these medications.
  • Anti-anxiety medications, including benzodiazepines and Buspar (buspirone). They work by increasing the availability of GABA in the brain. GABA is a neurotransmitter that helps you feel calm. Anti-anxiety medications work more quickly than gabapentin and are sometimes recommended to treat symptoms of short-term or acute anxiety disorders like panic disorder.  
  • Beta blockers are a type of medication typically used to treat high blood pressure or heart conditions and they can also be helpful for treating performance-related anxiety like public speaking. They work by blocking adrenaline—a neurotransmitter responsible for many of the physical symptoms of anxiety like increased heart rate, shaking, trembling, and rapid breathing. Beta-blockers are only used ‘off-label’ for treating anxiety. Meaning the FDA has not approved their use for anxiety but there is some evidence suggesting they may be helpful.  

Depending on the severity of your anxiety and if you have other mental health conditions in addition to an anxiety disorder, your doctor may recommend a type of medication that is not included on this list. Your doctor may also recommend other treatment options, like cognitive behavioral therapy, alongside taking medication.

Learn more about different types of anxiety medication and which is best for you.

The bottom line

Gabapentin is a prescription medication that is FDA-approved to treat nerve pain and seizure disorders. Although research is limited, some studies suggest gabapentin may also be effective in treating anxiety disorders. Some doctors will prescribe it for this purpose—most often for people who don’t respond to other treatment options.

Anxiety disorders are complex and treatment with either medications, therapy like cognitive behavioral therapy or both can be highly effective for managing symptoms. If you are living with an anxiety disorder or think you might be, take the first step and book and appointment with a health professional like a primary care doctor, psychiatrist, or therapist. They will be able to work with you to find the best treatment option for your needs.  

Getting treatment for anxiety

If you’re ready to get treated for anxiety but aren’t sure where to start, take our free 10-minute assessment.  You can find out if Talkiatry is right for you and get matched with a psychiatrist that takes your insurance and can see you from the comfort of home.  

If you’d like to learn more about how psychiatrists can treat anxiety disorders like generalized anxiety disorder, or social phobia, and whether or not a psychiatrist might be right for you, check out: Online Anxiety Treatment

Anxiety FAQs

When should I seek help for anxiety?  

Anxious thoughts can be a normal part of life but if unwanted thoughts are making it hard to go about your day, this is a sign you should seek professional support. Psychiatry can help. You can see if Talkiatry is right for you by taking a free 10-minute assessment.

Is anxiety medication safe?

Prescription anxiety medication is FDA-approved and safe. Your psychiatrist or prescribing doctor should help you navigate your options for medications and answer any questions you have about the benefits and side effects of each medication.

About Talkiatry

Talkiatry is a national psychiatry practice that provides in-network, virtual care. Co-founded by a patient and a triple-board-certified psychiatrist, Talkiatry has over 300 doctors, 60 insurance partners, and first visits available in days. We treat patients with anxiety, bipolar disorder, depression, post-traumatic stress disorder (PTSD), ADHD, and more. Get started with a short online assessment.

The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.  

Sources

GoodRx Health | Gabapentin for Anxiety: Dosing, Side Effects, and More

IUPHAR/BPS Guide to Pharmacology |Gabapentin

Innovations in Clinical Neuroscience | Psychiatric Uses of Gabapentin

StatPearls | Propranolol

Mental Health America | What is GABA?

The Journal of Clinical Psychiatry | The Role of GABA in Anxiety Disorders

FDA (Food and Drug Administration) | Gabapentin Fact Sheet

Drugs | FDA

Biological rationale and potential clinical use of gabapentin and pregabalin in bipolar disorder, insomnia and anxiety: protocol for a systematic review and meta-analysis | BMJ Open

Gabapentin Treatment for Alcohol Dependence: A Randomized Controlled Trial | NCBI

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Frequently asked questions

Does Talkiatry take my insurance?

We're in network with major insurers, including:

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For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

About
Sophia Monsour, DO

Dr. Sophia Monsour holds the position of Chief Psychiatrist for Pennsylvania at Talkiatry. After completing residency in 2013 at Albany Medical Center, she has spent the past 9 years fulfilling her passion for integrated and specialty care for adults suffering from mental illness. Her years of experience has included working as an integrated care Psychiatrist at a community health center, a medical director of a Partial Hospital and Intensive Outpatient Program (PHP/IOP), and also working for an Assertive Community Treatment Team (ACT) specializing in the Serious Mentally Ill (SMI) population.

Most recently, she has been serving our veterans as the Outpatient Section Chief, Primary/Mental Health Integration Medical Director and Resident/Medical Student Coordinator at VA Pittsburgh. Dr. Monsour has an approachable style when treating individuals who suffer from various diagnoses, especially those with prior trauma. She provides supportive psychotherapy and at times uses psychodynamic therapy skills to address her patient’s current stressors and to identify the root cause of their ailment. She believes in a holistic approach and utilizes mindfulness as a technique along with medication management.

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