Rankings / Mood, Anxiety & Stress
Gabapentin / pregabalin
Mood, Anxiety & Stress · alpha-2-delta voltage-gated Ca channel modulator
Tier B
Bottom line
Read Off Label grades Gabapentin / pregabalin as B (6.4/10) based on strong evidence, moderate benefit magnitude, and a med-risk safety profile.
Frequently used off-label for anxiety despite only pregabalin having formal GAD approval (in Europe).
Studied, labeled, or reported-use context: Gabapentin: 300-3600 mg/day divided; pregabalin: 150-600 mg/day divided — Rx; not individualized guidance.
What the evidence says
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
Studied, labeled, or reported dose & route
Gabapentin: 300-3600 mg/day divided; pregabalin: 150-600 mg/day divided
This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.
Citations
- PubMed · PMID 19160223
- PubMed · PMID 27372524
- pmc.ncbi.nlm.nih.gov
- PubMed · PMID 41142233
- ClinicalTrials.gov · NCT02120703
A link means the source informed this entry; it does not mean every claim on the page comes from that source. If a citation looks wrong or you want a claim re-checked, send a correction.
Common questions
- What does the evidence show about Gabapentin / pregabalin's effects?
- Read Off Label rates the evidence for Gabapentin / pregabalin as Strong and the benefit magnitude as moderate, producing an overall grade of B (6.4/10). Frequently used off-label for anxiety despite only pregabalin having formal GAD approval (in Europe).
- What safety findings are reported for Gabapentin / pregabalin?
- Gabapentin / pregabalin has a med risk profile in the database. Med (sedation, edema, weight gain, cognitive dulling; withdrawal symptoms with abrupt discontinuation; abuse potential increasingly recognized — pregabalin Schedule V US, gabapentin scheduled in some states; suicidality label) Legal status: Rx (pregabalin Schedule V US).
- What doses or routes are reported for Gabapentin / pregabalin?
- Gabapentin: 300-3600 mg/day divided; pregabalin: 150-600 mg/day divided This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
- How does Gabapentin / pregabalin work?
- Bind α2δ subunit of voltage-gated calcium channels; reduce neurotransmitter release (including glutamate, NE, substance P); not GABAergic despite GABA-mimetic name
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.