Performance anxiety, social anxiety and similar anxiety-related issues have the potential to negatively affect your life, career and relationships. At the very least, anxiety can make living a fulfilled, happy life much more difficult than it needs to be.

These types of anxiety are not new. Many accomplished performers and artists still experience stage fright every time they get on the stage or in front of a camera, including big name stars like Adele, Whitney Cummings & Taylor Swift. The list of people suffering in private from bouts of anxiety related to conference calls, meetings, interviews, social gatherings and dates, is extremely long.

Gabapentin is an anticonvulsant drug that’s initial purpose was to control certain types of seizures in people who have epilepsy, relieving nerve pain from shingles, or calming restless leg syndrome ^[1]. But recently, Gabapentin has started to be used ‘off-label’ as a treatment for anxiety disorders. There is even some evidence to suggest that gabapentin can be helpful for individuals who struggle with alcohol use disorders or alcohol dependence.

In this article, we’ll look into how Gabapentin works to treat the symptoms of performance anxiety, and its effectiveness at doing so. We’ll also touch on Gabapentin dosages for anxiety, known side-effects or interactions you need to know about, and whether there are viable alternatives to Gabapentin available and how they match up to the prescription medication.

What is Gabapentin

Gabapentin is a prescription drug, most commonly sold under the brand name Neurontin, as well as Gralise, Horizant, SmartRx Gaba-V kit, Fanatrex, Gabarone and Neuraptine.

Originally approved as an anti-seizure medication, Gabapentin (Neurontin) is now one of the most popular medications in the country ^[2]. Although Gabapentin was not made for anxiety purposes, it is often used off-label as a treatment for anxiety even though it is not FDA-approved for treating anxiety conditions.

Several emerging studies have proven the effectiveness of gabapentin in fighting anxiety. In one such study, researchers tested a daily gabapentin dose of both 300mg daily and 900mg daily in women who had been treated for breast cancer and who had anxiety. Both doses of gabapentin improved anxiety symptoms after 4 weeks, compared to placebo (a pill with no medication in it) ^[3].

Recently, some US states have classified gabapentin as a controlled substance due to the potential for abuse if not used properly, and the risk of death from overdose if abused ^[4].

Is Gabapentin a beta-blocker?

No, Gabapentin is not a beta blocker. Gabapentin is actually from a group of medicines called anticonvulsants ^[7]. Beta-blockers, or beta-adrenergic blocking agents, have the primary function of blocking the release of adrenaline and other stress hormones in the body ^[8].

Over The Counter (OTC) Beta blockers like Propranolol, Carvedilol, Metoprolol, Nebivolol and Clonidine are typically prescribed by doctors for health conditions like high blood pressure, angina (chest pains), irregular heart rhythm (arrhythmia), and migraines. But it is now well-known that beta-blockers have also long been used by performers to deal with anxiety and stage fright ^[9]. We have an excellent article all about beta blockers being used for anxiety, and you can view it here.

How does Gabapentin work for Anxiety?

Gabapentin is a synthetic version of the neurotransmitter GABA (neurotransmitters are chemicals that carry signals between nerve cells), which means it mimics the role GABA plays in the body.

GABA, or Gamma-Aminobutyric Acid, is a naturally-occurring amino acid that acts as a neurotransmitter. GABA is widely recognized as having a calming effect, and GABA deficiency is believed to play a large part in anxiety disorders ^[5].

The GABA neurotransmitter can help slow down neurons firing in the brain, and Gabapentin works in a similar way; helping to quiet the brain and decrease pain transmission in nerves ^[1].

For seizures, gabapentin works by decreasing abnormal excitement in the brain. It can also change the way that the body processes (or ‘senses’) pain, which can help alleviate pain caused by shingles and similar conditions.

It’s worth noting that the exact mechanism of action of Gabapentin is not yet fully understood, but scientists do know that Gabapentin increases GABA in the brain through the process of increasing activity of the enzyme glutamate decarboxylase (GAD).

Additionally, Gabapentin is able to cross the blood-brain barrier through an amino acid transporter.

When Gabapentin binds to the calcium ion channels in the spine and brain, it is actually able to reduce the abnormal brain activity that causes seizures, tremors, and pain, making it an anti-epileptic drug of choice ^[6].

So while Gabapentin has proven effective at emulating how GABA works in the body, slowing down neurons firing in the brain and pain transmission in the nerves, by itself gabapentin isn’t the best anxiety treatment and so it isn’t commonly prescribed alone to treat anxiety-related issues.

More often, Gabapentin is prescribed to ease anxiety symptoms for someone who also has depression or bipolar disorder, as anxiety is commonly comorbid with depression and bipolar. A close look comparing seven different clinical trials on how successful gabapentin is for anxiety shows that gabapentin may be better than a placebo to treat generalized anxiety disorder (GAD), but not that much better ^[10]. Other studies have shown that Gabapentin may be slightly more promising for social anxiety disorder ^[11].

What is the recommended Gabapentin dosage for anxiety?

Like with most prescription drugs, Gabapentin is individually prescribed to patients with anxiety based on their age, health condition, and symptoms.

Your doctor may start Gabapentin treatment with the lowest dosage of 300mg per day which can be then increased. The tablets can be cut in half to take 3-4 times per day. Neurontin Gabapentin, in particular, has a short half-life, so most oral dosages are taken three times a day.

The dosage can then be increased every three to five days. Some people take 600 mg/day, others take 3,600 mg/day, the maximum dose approved by the FDA ^[1].

The difference in clinical results means it is a little tricky to determine how quickly gabapentin might work to help your anxiety, however the medication effect in other health conditions is linked to a 1-2 week time frame.

In the case of discontinuing treatment with Gabapentin, a doctor will recommend reducing the dose gradually. Ideally, it should take a minimum of a 1-week time frame.

Gabapentin Side-Effects & Downsides

Gabapentin is generally well-tolerated but, as with any medication, it can cause side effects; especially when taken in combination with other substances or medications. Reported common side effects of gabapentin include the following ^[2]:

• Tiredness or sleepiness
• Dizziness
• Weakness
• Mood changes
• Tremors
• Dry mouth
• Headache
• Constipation
• Fluid buildup

More serious but less common side effects of Gabapentin include the following (contact your doctor if you have any of these potentially serious side effects) ^[2]:

• Depression
• Severe skin rash
• Suicidal thoughts
• Anaphylaxis
• Seizure, if stopped abruptly

Gabapentin requires a prescription

Do note that, assuming your doctor approves of you taking gabapentin for your anxiety, and writes a prescription, you’ll have to refill that prescription every time you run out.

This will not be an issue if you only plan on using gabapentin a few times, but if you start using Neurontin more often, then it could become a significant inconvenience.

Gabapentin Alternatives For Anxiety

If you’re not too excited about becoming dependent on gabapentin whenever you want/need to perform, or having to deal with the potential side-effects of the drug, or even just having to get a prescription whenever you run out: you may be wondering if there are natural alternatives to gabapentin?

A natural alternative would achieve the same (or better) end-result, which is to provide relief from symptoms of anxiety.

But a good alternative to gabapentin would provide anxiety relief by supporting your mind and body in a way that, over time, makes you more resilient. You should become better equipped to handle any stress responses that come your way and learn to think about your performances in a way that makes them less stressful, in the first place.

The most effective natural remedy to performance anxiety that I know of is PerformZen, which I reviewed here.

PerformZen has proved extremely effective, in my experience, at treating performance anxiety as it contains a combination of GABA & L-theanine, which help boost mental clarity; Theacrine, which aids mental clarity and energy; Ginkgo Biloba, which is an effective stress reducer; plus vitamins and minerals like Magnesium & Vitamin B6, which have proven effective in reducing even severe cases of stress.

This combination provides the positive anti-anxiety effects of Gabapentin, but also boosts alertness and mental clarity, which are more subtle symptoms of performance anxiety that gabapentin does not address. Overall, this may mean a natural solution such as PerformZen is not only safer, but more effective than gabapentin for performance anxiety!

So is Gabapentin the best solution for Anxiety Symptoms?

Gabapentin is a very common prescription medication in the US, and it has been used to treat several different conditions effectively, including neuropathy, seizures, and restless legs syndrome. Used off-label, Gabapentin has shown to be effective at helping treat symptoms of anxiety, postoperative surgical pain, alcohol withdrawal, cannabis withdrawal, and even hot flashes in women.

There is no question that Gabapentin is a very potent and effective drug, especially when combined (as advised by a licensed medical professional only) with certain other drugs. For the express purposes of reducing anxiety symptoms, however, gabapentin can provide a much-needed relief from physical anxiety symptoms so you can get through what you need to do. But gabapentin, or any other drug, will never be the solution you’re really looking for, which is to not be fearful about anxiety in the first place.

To overcome generalized or performance anxiety in the long term, consider natural alternatives like the ones we list here, or try a natural supplement like PerformZen.

In the meantime, If you are considering gabapentin as a quick-fix for your anxiety symptoms, be sure to consult with your doctor first to make sure it is the right solution for you.