Using Gabapentin for Anxiety and Depression

Did you know that Gabapentin might be helpful for depression and anxiety?

Gabapentin is an anticonvulsant drug that also goes by Neurontin, Gralise, or Gaborone. It’s initial purpose was to control certain types of seizures in people who have epilepsy, relieving nerve pain from shingles, or calming restless leg syndrome.

Gabapentin has also been used off-label as a treatment for anxiety disorders. It’s possible that your psychiatric provider may prescribe gabapentin to help alleviate some of the symptoms associated with these mental health disorders. Additionally, there is some evidence to suggest that gabapentin can be helpful for individuals who struggle with alcohol use disorders or alcohol dependence.

Let’s take a look at how gabapentin works and why you may be prescribed this medication for anxiety.

How does Gabapentin work?

Gabapentin is a synthetic version of the neurotransmitter GABA, which means it mimics the role GABA plays in the body. Neurotransmitters are chemicals that carry signals between nerve cells.

The GABA neurotransmitter can help slow down neurons firing in the brain. Gabapentin works in a similar way; it can help quiet the brain and decrease pain transmission in your nerves.

For seizures, gabapentin works by decreasing abnormal excitement in the brain. It can also change the way that the body processes pain, which can help alleviate pain caused by shingles.

While studies don’t typically show effectiveness for improving symptoms of depression, there is evidence that gabapentin may have some benefit for anxiety disorders. A rat study found that gabapentin produced behavioral changes suggestive of anxiolysis, or feelings of calmness.

Additionally, a case study of one individual found a clear inverse relationship between dosage of gabapentin and anxiety. The individual — who did not respond well to traditional antidepressant medications such as SSRIs — reported that her anxiety levels were very low on days when she took gabapentin.

So while there is some evidence that gabapentin can be used as a novel medication to treat anxiety and depression, there is not enough research to explain its therapeutic mechanisms.

Even so, your provider may determine that Gabapentin for anxiety or depression is worth prescribing. If so, here are some things you should know.

How to take Gabapentin for anxiety

If you are prescribed gabapentin for anxiety, you should follow the exact dosing prescribed by your provider — the dosing information provided below is for educational purposes only. 

Gabapentin can come in a capsule, tablet, or oral solution, but you’ll likely be prescribed capsules to help with anxiety. It is usually taken with a full glass of water, with or without food.

Antacids should not be taken within two hours before or after using gabapentin. Antacids can make it harder for your body to absorb gabapentin, making it less effective.

Potential side effects of Gabapentin

As with any medication, side effects may occur when taking gabapentin for anxiety. The main side effects include:

• Dizziness
• Fatigue
• Agitation
• Changes in libido, or sex drive
• Tremors
• Unsteadiness
• Nystagmus (involuntary eye movement)
• Blurred vision

Some of these side effects may resolve after continued use, but if they become severe or long term, reach out to your psychiatric provider immediately.

Gabapentin prescriptions for anxiety

Since gabapentin is a prescription medication, you’ll need to get a prescription from a doctor or psychiatric provider — only after you’ve demonstrated symptoms of anxiety and have been screened for  gabapentin allergies. Additionally, you may not be a candidate if you take other medications that have contraindications to gabapentin.

Your provider will provide specific dosing instructions, including a guideline on how frequently you should take gabapentin for your anxiety. As Psycom explains, your dose may start small and increase over time. For anxiety, the dosage of gabapentin will often start at 300 mg once in the evening. The dose can then be increased every three to five days. Some people take 600 mg/day, others take 3,600 mg/day, the maximum dose approved by the FDA.

According to Psycom, gabapentin for depression may follow a different dosage pattern.  Dosage of between 900 and 2,000 mg a day works as a mood stabilizer or antidepressant. Some people experience improvement within a week after treatment initiation, others need more time to feel significant symptom relief.

The difference in clinical results means it’s a little tricky to determine how quickly gabapentin might work to help your anxiety.

At Brightside, we use gabapentin alongside other medicines to treat:

• Generalized anxiety disorder
• Hard-to-treat depression
• Insomnia
• Nerve pain
• Panic disorder
• Social anxiety

Adding Gabapentin into your anxiety treatment plan

For anxiety or depression, Gabapentin is typically prescribed alongside other treatment options — here are the most common:

Selective Serotonin Reuptake Inhibitors (SSRI)

SSRI medications are commonly prescribed alongside gabapentin for depression and anxiety. SSRIs work by preventing the reabsorption of serotonin into your brain’s neurons, making the neurotransmitter more abundant. Serotonin is a chemical that is thought to regulate mood and anxiety levels.

There are many different types of SSRIs, but some common examples include Zoloft, Prozac, and Lexapro. SSRIs typically cause fewer side effects than many other types of antidepressants, which is one of the reasons why they’re so popular.

Talk Therapy

Therapy is widely delivered to treat anxiety and depression for those prescribed gabapentin,  and it’s highly effective. Although there are many types of depression and anxiety therapy, Cognitive Behavioral Therapy (CBT) is particularly effective. Goal-oriented and structured, CBT addresses the source of irrational thought to alter unfavorable behaviors.

In fact, the most effective way to care for your mental health is to leverage a combination of medication and talk therapy — which enables a 60% better chance of recovery than just one treatment alone.

In conclusion

Gabapentin is an anticonvulsant medication that is prescribed for treating seizures and nerve pain associated with shingles. However, it also is known for producing anti-anxiolytic (anti-anxiety) effects, which is why gabapentin is often prescribed for treating anxiety.

Gabapentin is usually prescribed at a low dose to start but can be gradually increased as needed. While a psychiatric provider will likely not prescribe gabapentin for anxiety or depression as a first course of action, it may be used alongside other treatments to help improve symptoms.

A Brightside psychiatric provider can help you determine what treatment plan is right for you. We offer therapy and psychiatric care right from the comfort of home — including unlimited messaging with your provider and medications delivered right to your door. 

Fill out your complimentary assessment to see how Brightside can help you find the right care plan. 

 Please note: Prescribing decisions are always at the discretion of the provider who abides by your state’s regulations and restrictions. Brightside’s providers can’t prescribe Gabapentin in the following states: Alabama, Kentucky, Michigan, North Dakota, Tennessee, Virginia, or West Virginia.

 

Sources:

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

Gabapentin | MedlinePlus

The antiepileptic agent gabapentin (Neurontin) possesses anxiolytic-like and antinociceptive actions that are reversed by D-serine | National Library of Medicine

Treatment of Generalized Anxiety Disorder with gabapentin | NCBI

Gabapentin | Michigan Medicine

Serotonin | Hormone Health Network

Selective serotonin reuptake inhibitors (SSRIs) | Mayo Clinic

Gabapentin Therapy in Psychiatric Disorders: A Systematic Review | NCBI