Gabapentin for Anxiety: Understanding the Treatment Timeline

Gabapentin is a prescription medication that has been FDA-approved for conditions such as epilepsy and neuropathy but has also been found to relieve anxiety. How long does it take for gabapentin to work for anxiety? Does it provide fast relief like Xanax, or does it take longer to kick in like Prozac? When you need immediate and long-term support for severe anxiety symptoms, talk to your provider to find out which medication is most suitable.

Having an anxiety disorder can make everyday life feel more challenging. But you don't have to settle for constantly feeling tired and wired. Confidant Health offers virtual anxiety treatment and support to help you learn how to manage anxiety symptoms and stop them from interfering with your life. Schedule an online assessment now to start getting the help you need for anxiety disorders.

What Is Gabapentin?

Gabapentin is an anticonvulsant medication and a gamma-aminobutyric acid (GABA) analog, which helps increase levels of GABA in the brain. Gamma-aminobutyric acid blocks the transmission of certain signals between brain neurotransmitters, which has a calming effect on the mind and body.

Gabapentin is used to treat conditions related to overexcitement in the brain, such as:

• Shingles-related pain
• Epileptic seizures
• Restless leg syndrome
• Numbness or tingling in the extremities caused by diabetes
• Hot flashes in menopausal women or those being treated for breast cancer
• Alcohol withdrawal symptoms
• Anxiety

Since gabapentin stimulates GABA production, it can help reduce excessive activity in the brain that can trigger or exacerbate the above conditions.

Gabapentin for Anxiety

Although gabapentin may be prescribed to treat anxiety disorders, it is not FDA-approved for this use and is instead prescribed off-label. Some studies have shown a reduction in generalized anxiety and social anxiety symptoms when participants underwent a gabapentin regimen.

Benefits of Gabapentin for Anxiety

Gabapentin's ability to limit hyperactivity in brain neurotransmitters to reduce pain, seizures, and other involuntary movements, can also benefit people experiencing anxiety symptoms. Some of the benefits of gabapentin for anxiety include:

• Relief from generalized anxiety
• Relief from social phobia
• Safer to use than some other anxiety medications
• Can be used long-term
• Very affordable in its generic form
• Available in liquid form for those who have trouble swallowing pills

If you struggle with generalized anxiety disorder and haven't found a treatment option that provides enough relief, talk to your provider about gabapentin for anxiety.

Gabapentin Prescriptions for Anxiety

Although gabapentin is not currently FDA-approved to treat anxiety, your provider can prescribe this medication for you off-label. Used in conjunction with cognitive behavioral therapy and other prescription antidepressants, gabapentin can be a highly effective tool for managing chronic anxiety.

If your provider feels that gabapentin is appropriate for your anxiety treatment, they may prescribe one of the following:

• Generic gabapentin
• Gralise 
• Horizant 
• Neurontin

Each of these versions of gabapentin is available in different forms and strengths. Your provider will determine which would be appropriate to help you find relief from anxiety symptoms.

Gabapentin Dosage for Anxiety

The typical gabapentin dosage for anxiety treatment is 300 to 3,600 mg daily. This is similar to the usual gabapentin dosage for other conditions and may be broken into two or three daily doses for dosages on the higher end of the scale. Gabapentin prescriptions come in the following strengths:

Generic Gabapentin

• 600 mg and 800 mg tablets
• 100 mg, 300 mg, and 400 mg gelatin capsules
• 250 mg doses of oral solution 

Gralise

• 300 mg and 600 mg tablets

Horizant

• 300 mg and 600 mg extended-release tablets

Neurontin 

• 600 mg and 800 mg tablets
• 100 mg, 300 mg, and 400 mg gelatin capsules
• 250 mg doses of oral solution

Gabapentin Administration for Anxiety

Gabapentin is delivered in several forms:

• Capsules
• Tablets
• Extended-release tablets
• Oral solution

How you should take gabapentin depends on your specific prescription:

Generic Gabapentin

Generic gabapentin tablets may be broken in half if needed and taken with a glass of water. The capsule should be swallowed whole with water. Either form may be taken with or without food. The oral solution should be measured out using the measuring device included with your prescription and swallowed.

Gralise

Gralise tablets should be swallowed whole with a glass of water and taken with food.

Horizant

Horizant extended-release tablets should be swallowed whole with a glass of water and taken with food.

Neurontin

Neurontin tablets can be broken in half if needed and taken with a glass of water. The oral solution can be measured out using the accompanying spoon, syringe, or measuring cup and swallowed.If you are prescribed gabapentin for anxiety and take antacids that contain aluminum or magnesium, like Mylanta or Maalox, you should leave a two-hour window between these medications.

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How Long Does It Take for Gabapentin to Work for Anxiety?

Unlike fast-acting medications for anxiety, like alprazolam (Xanax), it can take several weeks for you to start feeling relief from gabapentin. One study showed that participants taking either 300 mg or 900 mg of gabapentin daily felt relief from anxiety symptoms after four weeks.

Your provider will likely start you at a low dose and then gradually increase the dose as needed to achieve optimal results. If you don't begin to experience relief from anxiety symptoms after a few weeks, talk to your provider about adjusting your dosage.

Gabapentin Side Effects

Common Side Effects

The calming effects of gabapentin can sometimes affect people a little too strongly, leading to common side effects like:

• Excessive sleepiness
• Fatigue
• Dizziness
• Difficulty speaking
• Weakness

Some people also experience mood changes, constipation, headache, and dry mouth.

Serious Side Effects

Although serious side effects of gabapentin are rare, some people may experience:

• Severe allergic reaction
• Seizure
• Depression
• Panic attacks
• Suicidal thoughts
• Bluish color to your lips, fingers, or toes
• Trouble urinating
• Blood in your urine

If you have any of the above serious side effects of gabapentin, immediately reach out to your provider for guidance. In some cases, such as anaphylaxis, you may need to seek emergency medical treatment.

Side Effects if Misused

Since gabapentin has a calming effect on the mind and body, similar to benzodiazepines and opioids, some people may misuse it to achieve a more enhanced state of sedation. Misusing gabapentin can lead to various side effects, such as:

• Dizziness
• Excessive sleepiness
• Insomnia
• Respiratory depression
• Suicidal thoughts
• Temporary memory loss
• Tremors
• Worsening anxiety

You can also develop a dependence or addiction to gabapentin if misusing it, which can instigate withdrawal symptoms if you try to quit or cut back on your dose.

Possible Allergic Reactions

Some people may experience allergic reactions to gabapentin. Some signs of allergic reaction to your medication include:

• Difficulty breathing
• Fever
• Nausea and vomiting
• Skin rash
• Swollen, tender, or painful lymph glands
• Yellowing of the eyes or skin

If you experience any of the above signs of allergic reaction to gabapentin, you should consult your provider right away or seek emergency medical attention.

Gabapentin Interactions

Any medications that depress the central nervous system should not be taken alongside gabapentin without your provider's approval. Gabapentin interactions with these types of medications can exaggerate the sedating effects of both. For example, you can become extremely dizzy and confused, your breathing can slow to dangerously low levels, and you may lose consciousness. Some medications that interact with gabapentin in this way include:

• Alcohol
• Antihistamines like Benadryl and Claritin
• Benzodiazepines like Xanax or Valium
• Sleep medications like Ambien and Lunesta
• Opioids like morphine and OxyContin

As mentioned, you should not take gabapentin at the same time as antacids containing aluminum or magnesium. Both of these substances can lower the levels of gabapentin in your body, making your medication less effective. Take your prescribed gabapentin and antacids at least two hours apart to avoid interactions.

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Gabapentin for Anxiety FAQs

Can gabapentin make my anxiety worse?

If misused, gabapentin can exacerbate anxiety symptoms. Certain people may also respond to gabapentin differently than others, experiencing irritability, agitation, nervousness, hostility, and suicidal thoughts. If you notice your anxiety symptoms worsening after starting a gabapentin regimen, reach out to your provider immediately.

What is the best time to take gabapentin?

If you are prescribed a once-daily dose of gabapentin, the best time to take it would be in the evening. This medication can make you feel tired, so taking it before bed will eliminate the disruption of excessive sleepiness or fatigue during the daytime.

What are gabapentin alternatives?

If you experience severe side effects from gabapentin or you aren't experiencing the desired relief from your anxiety symptoms, You may wish to look at gabapentin alternatives. Some alternatives to gabapentin for anxiety are:

• Cymbalta
• Depakote
• Elavil
• Klonopin
• Lamictal 
• Trileptal

Talk to your provider about your treatment options if gabapentin is not working for your anxiety symptoms. They may change your dosage, switch you to one of the above medications, or try another anxiety medication. 

Getting Help for Anxiety

Anxiety is one of the most common mental health disorders, with generalized anxiety disorder (GAD) affecting nearly 7 million adults in the United States. Anxiety can cause a range of symptoms, such as feelings of worry, fear, and panic. It can also lead to physical symptoms such as headaches, nausea, and muscle tension. 

Less than half of people struggling with anxiety seek treatment. But without the proper treatment, anxiety can continue to interfere with your overall health and happiness. Three primary factors in managing anxiety are:

Behavioral Therapy 

Behavioral therapy can help you identify what triggers your anxiety and teach you new ways to respond to stressful situations.

Medications

Anxiety medications can be helpful for some people, but not all medications work for each person. It can take some time to find the right medication for you and for it to start working. Keep in mind that medications are not a cure for anxiety and are often most effective when combined with behavioral therapy and anxiety management techniques.

Anxiety Management Techniques

Your therapist may teach you anxiety management techniques during your sessions, but you can also explore different techniques on your own. Some common methods that help with anxiety management are:

• Breathing exercises
• Meditation
• Visualization
• Exercise 
• Yoga
• Qi gong

Try different anxiety management techniques to see which ones work best to relieve your symptoms. Breathing exercises are often a favorite since they can be done anywhere, anytime, and don't require any tools or equipment. You can also do them when out in public without anyone noticing, making them the most discreet option.

Get Virtual Anxiety Treatment and Support at Confidant Health

Living with anxiety can be tough and even interfere with your life goals. But with the help of Confidant Health’s online anxiety treatment and support, you no longer have to accept chronic anxiety as part of your daily life. Download our app today to find out how we can help you get control of anxiety, so it no longer controls you.

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