Gabapentin (Neurontin)
Anticonvulsant (glutamate alpha-2 delta calcium channel blocker)
- Generalized Anxiety [3]
- Hypnotic [3]
- Social Anxiety [3]
- Panic [4]
- Cannabis [2]
- Alcohol (stabilizes sleep, may help WD) [2]
- Restless Legs [1]
- Bruxism [3]
- Fibromylagia [2]
Features
Dosing
DOSE: (can divide bit-tid or give all at night): Anxiety (300-3600 mg/d), Bipolar (900-4800 mg/d), Alcohol use disorder (600-2400 mg/d), Insomnia (100-900/night mg qhs), RLS (300-2400 mg qha), Akathisia (300-2400 mg/d). If dividing BID-TID, give more at night.
Above 900 mg, less and less gets absorbed, so 2400 mg is only 1.5 times more than 900 mg. Lower dose in renal insufficiency.
Bruxism: 300 mg qhs.
Agitation and insomnia in dementia: 100 mg prn
| Daily Dose | How Much Gets Absorbed |
|---|---|
| 900 mg | 540 mg |
| 1200 mg | 564 mg |
| 2400 mg | 816 mg |
| 3600 mg | 1188 mg |
| 4800 mg | 1296 mg |
Management
TOLERABILITY: Dizziness, fatigue, “drunk like feelings”
EMR Text
Anxiety
Gabapentin use based on small controlled trials in anxiety, including social anxiety disorder, panic disorder, and non-specific anxiety.
Gabapentin side effects, including sedative and motoric effects, reviewed with patient.
Insomnia
Gabapentin use based on small controlled trials where it improved sleep quality.
Gabapentin side effects, including sedative and motoric effects, reviewed with patient.
Alcohol
Gabapentin use based on small controlled trials in alcohol use disorder, where it improved sleep, reduced withdrawal symptoms, and may improve sobriety.
Gabapentin side effects, including sedative and motoric effects, reviewed with patient.
Cannabis
Gabapentin use based on a controlled trial in cannabis use disorder.
Gabapentin side effects, including sedative and motoric effects, reviewed with patient.
Restless leg syndrome
Gabapentin use based on a controlled trial in cannabis use disorder.
Gabapentin side effects, including sedative and motoric effects, reviewed with patient.