Gabapentin / pregabalin
Mental Health · alpha-2-delta voltage-gated Ca channel modulator
Tier B-
What this is
Frequently used off-label for anxiety despite only pregabalin having formal GAD approval (in Europe). Growing recognition of abuse — particularly pregabalin in combination with opioids. Misleading narrative of 'non-habit-forming' has shifted as evidence of withdrawal syndromes accumulated.
Mechanism
Bind α2δ subunit of voltage-gated calcium channels; reduce neurotransmitter release (including glutamate, NE, substance P); not GABAergic despite GABA-mimetic name
Dose & route
Gabapentin: 300-3600 mg/day divided; pregabalin: 150-600 mg/day divided
Citations
- https://pubmed.ncbi.nlm.nih.gov/19160223/
- https://pubmed.ncbi.nlm.nih.gov/27372524/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6178707/
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.