Does gabapentin act like a benzo?

October 9, 2025 •

3 min read

In 2019, 69 million gabapentin prescriptions were dispensed in the U.S., making it the seventh most commonly prescribed medication. This raises a common question: Does gabapentin act like a benzo? While they can produce similar sedative effects, they are fundamentally different medications.

Quick Summary

Gabapentin and benzodiazepines are not the same class of drug. Despite some overlap in sedative effects, they have distinct pharmacological mechanisms, safety profiles, and potential for dependence.

Key Points

Different Mechanisms: Gabapentin inhibits voltage-gated calcium channels, while benzodiazepines enhance the activity of GABA-A receptors.
Not a Benzo: Despite its name being similar to GABA, gabapentin does not directly bind to or act on GABA receptors like benzodiazepines do.
Onset of Action: Benzodiazepines act rapidly (within minutes to an hour), whereas gabapentin's therapeutic effects can take days to build.
Risk Profiles: Benzodiazepines have a high potential for dependence and addiction. Gabapentin's risk is lower but still significant, especially when misused or in patients with a history of substance abuse.
Controlled Status: Benzodiazepines are federally controlled substances (Schedule IV). Gabapentin is not federally controlled but is scheduled by several individual states due to misuse potential.
Combined Dangers: Mixing either drug with other CNS depressants like opioids significantly increases the risk of severe respiratory depression and fatal overdose.

Understanding Gabapentin and Benzodiazepines

Gabapentin and benzodiazepines are both medications used to affect the central nervous system, sometimes for similar conditions like anxiety or seizures. However, they belong to different drug classes and have distinct mechanisms of action. While effects like sedation might feel similar, their pharmacology, risks, and approved uses differ.

What is Gabapentin?

Gabapentin is an anticonvulsant medication approved by the FDA in 1993. Although structurally similar to GABA, it does not bind to GABA receptors. Its main action is inhibiting voltage-gated calcium channels, specifically the alpha-2-delta subunit. This action reduces the release of excitatory neurotransmitters, calming neuronal activity.

FDA-Approved Uses:

Adjunctive therapy for partial seizures.
Postherpetic neuralgia.

Common Off-Label Uses: A significant number of gabapentin prescriptions are for off-label uses, including anxiety disorders, neuropathic pain, and alcohol withdrawal.

What are Benzodiazepines?

Benzodiazepines, or "benzos," are sedative-hypnotic drugs. They work by enhancing the effect of GABA, the brain's main inhibitory neurotransmitter, at the GABA-A receptor. This increases chloride ion flow into neurons, reducing their activity and producing a calming effect.

Commonly Prescribed For:

Anxiety and panic disorders.
Insomnia.
Seizures and muscle spasms.
Alcohol withdrawal.

The Core Difference: Mechanism of Action

The key difference lies in their interaction with the GABA system. Benzodiazepines directly enhance GABA-A receptor activity. Gabapentin, despite its name, does not directly affect GABA receptors. It works indirectly by binding to calcium channels to reduce excitatory neurotransmitter release.

Comparison: Gabapentin vs. Benzodiazepines


Feature	Gabapentin	Benzodiazepines
Mechanism	Binds to voltage-gated calcium channels.	Enhances GABA at GABA-A receptors.
Primary Uses	Seizures, neuropathic pain. Off-label for anxiety, alcohol withdrawal.	Anxiety, insomnia, seizures, muscle spasms.
Onset of Action	Slow, days for full effect.	Fast, 15-60 minutes.
Common Side Effects	Dizziness, fatigue, vision changes.	Drowsiness, sedation, cognitive impairment.
Addiction Risk	Lower, but potential for tolerance, withdrawal, misuse.	High risk for physical dependence and addiction.
Withdrawal	Anxiety, irritability, insomnia.	Severe and potentially dangerous, including seizures.
Controlled Status	Not federally controlled; Schedule V in some states.	Federally Schedule IV controlled substances.

Risks and Considerations

Concerns exist about gabapentin's potential for misuse and addiction, especially in individuals with a history of substance use. Combining gabapentin or benzodiazepines with other CNS depressants like opioids is particularly dangerous. The FDA warns of serious breathing problems when gabapentin is used with opioids or other CNS depressants. Combining gabapentin with opioids increases the risk of opioid-related death. Similarly, using gabapentin and benzodiazepines together can increase sedation and other cognitive issues. Studies show concurrent use of gabapentin, opioids, and benzodiazepines is linked to higher risk of respiratory depression and overdose. Benzodiazepines have a high risk of dependence, and withdrawal can be severe; they should not be stopped abruptly.

Conclusion

In summary, gabapentin does not act like a benzodiazepine. They are distinct medications with different mechanisms, safety profiles, and effects. While both can cause sedation and treat some similar conditions, they are not interchangeable. Benzodiazepines quickly enhance GABA's inhibitory effects with a high dependence risk. Gabapentin acts more slowly and indirectly via calcium channels. While potentially safer in some ways, risks of misuse and dangerous interactions, especially with other depressants, are significant. Always consult a healthcare provider regarding medication use.

For more information from an authoritative source, you can visit the FDA's safety announcement on gabapentinoids.

Frequently Asked Questions

No, gabapentin is not a benzodiazepine. They belong to different drug classes and work through different mechanisms in the brain.

The confusion arises because both can be used to treat anxiety and can cause similar side effects like sedation and dizziness. Also, gabapentin's name is similar to the neurotransmitter GABA, which is the primary target of benzodiazepines.

The main difference is their mechanism. Xanax (a benzodiazepine) directly enhances the brain's main inhibitory neurotransmitter, GABA. Gabapentin works indirectly by binding to voltage-gated calcium channels to reduce the release of excitatory neurotransmitters.

Combining gabapentin and benzodiazepines magnifies central nervous system depression, increasing risks of excessive sedation, cognitive impairment, and breathing difficulties. This combination should only be used under strict medical guidance.

Gabapentin has a lower risk of addiction than benzodiazepines, but it can lead to tolerance, physical dependence, and withdrawal if stopped suddenly. The risk of misuse is higher in people with a history of substance use disorder.

Gabapentin withdrawal symptoms can appear 12 to 48 hours after stopping and may include anxiety, irritability, restlessness, insomnia, sweating, and tremors. The symptoms can resemble benzodiazepine or alcohol withdrawal.

Gabapentin is not a controlled substance at the federal level in the United States. However, due to increasing concerns about misuse, several states have independently classified it as a Schedule V controlled substance, requiring stricter monitoring.