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Drug Info

Does gabapentin help with depression?

Gabapentin is an anticonvulsant medication prescribed to treat seizures and nerve pain. It is not typically used as an antidepressant.
Rebecca Rovenstine writer headshot
By | Jun. 26, 2024 Medically reviewed by Peter Lourgos, MD, JD
Rx capsules: Gabapentin for depression

Key takeaways

  • Gabapentin is not commonly used to treat depression, but some recent studies indicate it may treat anxiety, alcohol withdrawal, and alcohol use disorder. A normal dose of gabapentin for adults can be anywhere from 100 mg to 3600 mg each day.

  • Common side effects of gabapentin include dizziness, weakness, and upset stomach.

In this article:

Gabapentin, a prescription drug, is an anticonvulsant medication used to treat seizures and also helps treat nerve pain for people with conditions such as shingles or restless leg syndrome. 

In recent years, some doctors have begun prescribing gabapentin to also treat depression, but is this the best course of treatment? Keep reading as we dive into whether gabapentin is a good choice to treat depression.

Does gabapentin help with depression?

“The U.S. Food and Drug Administration does not approve Gabapentin for depression and is not typically prescribed by psychiatrists to treat depression,” said Dr. Ozan Toy, MD, MPH and Chief Medical Officer at Telapsychiatry. He further explained why this medication is not a good option: “Gabapentin could worsen depression symptoms as a side effect of the medication, particularly when anxiety is present.”

Gabapentin is not an antidepressant. It is unusual for providers to administer gabapentin for depression, with only a small portion of healthcare providers opting for this course of treatment. 

“Approximately 5% of gabapentin prescriptions are prescribed off-label to treat depression,” explained Dr. Sandra Quinn, MD and Medical Director of Adult Outpatient Services and Adult Interventional Psychiatrist at PrairieCare. “Gabapentin is only FDA-approved for the treatment of seizures and postherpetic neuralgia.”

In 2022, Innovations in Clinical Neuroscience published a study about the psychiatric uses of gabapentin. The literature review found that while gabapentin use had been found to treat alcohol withdrawal and alcohol use disorder along with some cases of social anxiety disorder and severe panic disorder, it was not supported in those with bipolar disorder, major depressive disorder (MDD), posttraumatic stress disorder (PTSD), or obsessive-compulsive disorder (OCD). 

England’s Addictive Behaviors journal also looked into gabapentin and the treatment of mental health conditions in 2021. The study explains that gabapentinoids, which include gabapentin and pregabalin, have some overlap in action with benzodiazepines used to treat anxiety, and like benzodiazepines, gabapentin can become addictive but typically doesn’t work any better than the placebo group. 

Ultimately, the Addictive Behaviors journal did not support the use of gabapentin for mental health treatment with the conclusion, “The use of gabapentinoids off-label for other psychiatric conditions should also be re-considered. In general, psychotropic medications require longer-term efficacy and safety studies before allowing widespread use.”

RELATED: What causes depression? Diagnosis, prevention, and treatment

How does gabapentin work for depression?

Gabapentin belongs to a class of drugs called anticonvulsants and may be sold under the brand name Gralise, Horizant, or Neuraptine. The prescription medication reduces the brain’s abnormal electrical activity and blocks pain messages in the brain and spine, which explains how it helps treat seizure disorders and alleviates nerve pain.

Neither of these known processes is likely to help with depression.

Gabapentin dosage for depression

“Gabapentin has a wide dosage range, depending on what it treats,” explained Dr. Quinn. “Doses range from 100 mg to 3600 mg total daily, divided 1-3 times daily.”

Gabapentin doses may vary based on whether they’re treating seizures, nerve pain, or other off-label uses. Pediatric doses for children will vary based on weight. For adults or anyone taking gabapentin, dosing should start on the low end and be adjusted to higher doses as needed since some studies have shown gabapentin can have addictive qualities. Because of this, it’s also important to tell your doctor if you have a substance use disorder or an alcohol use disorder that may make you more susceptible to addiction.

“Dosing adjustments may be necessary for older adult patients mainly due to the risk of sedation and the possibility of confusion or dizziness,” added Dr. Toy.

Gabapentin side effects and interactions

Like any prescription medication, there are possible side effects from gabapentin and interactions with other prescription drugs a person may take. Some of these side effects may vary and worsen in older adults.

Side effects

The most common side effects and adverse effects of gabapentin include:

  • Dizziness
  • Weakness and sleepiness
  • Nausea and Vomiting
  • Diarrhea
  • Swelling of the extremities
  • Mood changes, including depressive symptoms
  • Blurred vision or uncontrolled eye movements
  • Dry mouth
  • Weight gain
  • Headaches

There are potential risks of more serious side effects that could be life-threatening. These include withdrawal symptoms, suicidal thoughts, and severe allergic reactions. It’s important for a person to discuss stopping gabapentin with their doctor since the drug can alter brain chemistry and may cause unpleasant withdrawal symptoms with discontinued use.

Interactions

Gabapentin may interact with alcohol and caffeine. Common drug interactions with gabapentin include the following: 

  • Opioids like MS Contin (morphine sulfate), Roxicodone (oxycodone), Percocet (oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)
  • Antacids like Maalox and Mylanta
  • Benzodiazepines like Xanax (alprazolam), Ativan (lorazepam) or Klonopin (clonazepam)
  • Antihistamines like Benadryl (diphenhydramine) or Vistaril (hydroxyzine)
  • Sedatives like Ambien (zolpidem) or Lunesta (eszopiclone)
  • Muscle relaxants like Flexeril (cyclobenzaprine) or baclofen

RELATED: Can you take gabapentin with Flexeril?

How to get a gabapentin prescription for depression?

If you suspect you have depression, it’s important to discuss these symptoms with your doctor, as there are many medications on the market for improving mental health disorders.

You can always ask your doctor for the medication you’d prefer. Still, it is very unlikely a healthcare professional would prescribe gabapentin for depression since research does not support this use.

Gabapentin alternatives for depression

“There is much more evidence for treating depression with other medications,” said Dr. Quinn. 

According to Dr. Quinn, these medications include: 

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Tricyclic antidepressants (TCAs)
  • Monoamine oxidase inhibitors (MAOIs)

Other treatment options suggested by Dr. Quinn included psychotherapy, transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), and Ketamine. Another mental illness treatment popular among healthcare providers is cognitive behavioral therapy.

“In particular, SNRIs can have similar impacts in terms of helping anxiety but also being helpful for conditions that cause neuropathic pain,” explained Dr. Toy to those who want the additional benefits from gabapentin. “Often duloxetine, which is an SNRI, is prescribed for individuals who may have neuropathic pain issues but also suffer from depression or anxiety.”

SingleCare also has a full list of gabapentin alternatives for those interested.

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