What Does Gabapentin Do Mentally? A Comprehensive Look

October 10, 2025 •

4 min read

While commonly prescribed for physical conditions like nerve pain and seizures, over 99% of gabapentin prescriptions in a 2011-2016 analysis were for off-label uses, many targeting psychiatric symptoms. This highlights the necessity of understanding what does gabapentin do mentally, from its intended calming effects to its potential adverse cognitive and mood-related consequences.

Quick Summary

Gabapentin, an anticonvulsant, has complex mental effects stemming from its action on calcium channels and neurotransmitters, leading to both therapeutic anxiolytic properties and adverse cognitive and mood-related side effects. Evidence supports its use for certain anxiety disorders and alcohol withdrawal, but not for major depression or bipolar disorder, emphasizing the need for careful monitoring during use and when considering discontinuation.

Key Points

Reduces Excitatory Neurotransmitters: Gabapentin works mentally by modulating calcium channels, which in turn decreases the release of stimulating neurotransmitters, creating a calming effect.
Offers Anxiolytic Effects: It is sometimes used off-label to help manage anxiety and panic symptoms, and is effective for social anxiety disorder, though not proven for generalized anxiety disorder.
Aids in Alcohol Withdrawal: Studies have shown that gabapentin can be an effective treatment for alcohol dependence and can help reduce associated withdrawal symptoms.
Causes Cognitive Side Effects: Common mental side effects include drowsiness, dizziness, brain fog, and memory problems, particularly with higher doses or long-term use.
May Cause Mood Changes: It can cause or worsen mood swings, depression, and irritability, and in rare cases, is linked to suicidal thoughts or behaviors.
Risks Dependence and Withdrawal: Abruptly stopping gabapentin can lead to mental withdrawal symptoms like anxiety, restlessness, and mood swings, emphasizing the need for medical supervision during discontinuation.
Ineffective for Major Depression and Bipolar Disorder: Despite past claims, controlled studies provide no significant evidence that gabapentin is effective for treating major depressive disorder or bipolar disorder.

How gabapentin affects the brain: The underlying mechanisms

Gabapentin was originally developed as an analog of the neurotransmitter gamma-aminobutyric acid (GABA), but its primary mental effects are not directly related to GABA receptors. Instead, its main mechanism involves binding to the $\alpha_2\delta$ subunit of voltage-gated calcium channels in the brain and spinal cord.

Affecting neurotransmitter release

By binding to these calcium channels, gabapentin reduces the release of several excitatory neurotransmitters, such as glutamate. This reduction in excessive nerve activity can produce a calming, inhibitory effect on the central nervous system, which is believed to be responsible for both its anti-seizure and anxiolytic properties. While not directly acting on GABA receptors, it can indirectly modulate GABA activity, which further contributes to its calming effects. However, this complex interaction with brain chemistry means the mental impact of gabapentin can vary significantly between individuals and may not always be straightforward or positive.

Approved and off-label mental health uses

While FDA-approved uses for gabapentin are limited to treating nerve pain from shingles (postherpetic neuralgia) and certain types of seizures, it is frequently prescribed off-label for psychiatric conditions.

Evidence-supported off-label uses

Anxiety: For some patients, gabapentin has shown benefit in treating anxiety, including social anxiety disorder and, in some cases, severe panic disorder. Its use in generalized anxiety disorder (GAD) is less clear, but some case studies suggest it can be effective.
Alcohol Use Disorder: Several randomized controlled trials support gabapentin's efficacy in treating alcohol dependence and withdrawal symptoms. Some studies have investigated the use of gabapentin in the management of alcohol dependence and withdrawal.
Insomnia: As a side effect, gabapentin often causes drowsiness, which can be therapeutically useful for individuals with anxiety-related insomnia.

Risks and adverse psychological effects

Gabapentin's effects on the mind are not universally beneficial. Many individuals experience significant negative side effects, particularly with higher amounts or prolonged use.

Cognitive impairment

Commonly reported mental side effects include drowsiness, dizziness, brain fog, and memory loss. These effects can particularly impact concentration and focus.

Mood changes and behavioral issues

Gabapentin can cause or worsen feelings of depression and mood swings. In rare instances, there is a risk of suicidal thoughts, especially early in treatment. Behavioral issues like aggression have also been noted, particularly in children.

Neurological and long-term concerns

There are concerns about a potential link between long-term gabapentin use for chronic pain and cognitive impairment or dementia, especially in older adults. Further research is needed to establish causality.

Off-label uses with insufficient evidence

While once believed to be effective for a broad range of psychiatric issues, robust research has refuted many of these claims.

Conditions not effectively treated by gabapentin

Controlled trials indicate gabapentin is not more effective than placebo for bipolar disorder. There's also limited evidence for its effectiveness in major depressive disorder (MDD), and it may even worsen symptoms. Research does not support its use for PTSD or OCD.

Comparing gabapentin mentally with other psychotropic medications

Understanding how gabapentin's mental effects compare to those of other psychotropic drugs can help in treatment decisions.


Feature	Gabapentin (Neurontin)	Benzodiazepines (e.g., Xanax)	SSRIs (e.g., Sertraline)
Mechanism	Modulates calcium channels, reduces excitatory neurotransmitters.	Enhance GABA activity, rapidly calming the nervous system.	Increase serotonin levels in the brain over time.
Speed of Action	Slow, often taking days or weeks to show effect for anxiety.	Fast-acting, providing rapid relief for acute anxiety or panic.	Slow, typically requiring several weeks to reach full efficacy.
Best For	Chronic anxiety, alcohol withdrawal, anxiety with comorbid nerve pain.	Acute anxiety, panic attacks, short-term use.	Long-term management of anxiety and depression.
Addiction Risk	Lower dependency risk than benzodiazepines but potential for abuse exists, especially with other substance use.	High risk of physical dependence and addiction, especially with long-term use.	No significant addiction risk.
Common Mental Side Effects	Dizziness, drowsiness, brain fog, mood changes.	Drowsiness, sedation, memory problems.	Nausea, trouble sleeping, sexual side effects, agitation.

Navigating dependency and withdrawal

Gabapentin carries a risk of physical dependence and withdrawal, especially in individuals with a history of substance use or those taking higher amounts.

Abuse potential and psychological drive

Some individuals misuse gabapentin for its euphoric or calming effects, particularly if they have a history of substance abuse. Combining it with other substances, like opioids, increases the risk of serious side effects.

Mental withdrawal symptoms

Stopping gabapentin abruptly can lead to mental withdrawal symptoms including increased anxiety, irritability, mood swings, insomnia, and confusion. Though rare, suicidal thoughts can also occur during withdrawal. A gradual tapering schedule under medical supervision is crucial to minimize these effects.

Conclusion: The complex mental effects of gabapentin

Gabapentin has a complex impact on mental health. While it can be beneficial for certain off-label uses like specific anxiety disorders and alcohol withdrawal, it is not effective for conditions such as bipolar disorder or major depression. Furthermore, it can cause negative mental side effects, including cognitive issues and mood changes, and carries a risk of dependence. Long-term use may also have potential neurocognitive risks. Discussing the potential benefits and risks with a healthcare provider is essential for anyone considering or taking gabapentin.

For more information on the psychiatric uses of gabapentin and other medications, consult peer-reviewed resources like PubMed Central, which provides evidence-based reviews of clinical trials.

Frequently Asked Questions

Yes, gabapentin can cause or worsen depression, mood swings, irritability, and anxiety in some individuals. Patients with a history of mood disorders may be at a higher risk of experiencing these side effects.

Yes, cognitive issues such as brain fog, difficulty concentrating, and memory problems have been reported as side effects of gabapentin. These effects are often associated with higher doses.

Gabapentin has shown some efficacy for certain anxiety disorders, like social anxiety and severe panic disorder, particularly in off-label use. However, its effectiveness for generalized anxiety disorder is not as well-supported by robust evidence.

Gabapentin is not an antidepressant or an FDA-approved mood stabilizer. Controlled studies have shown it is largely ineffective for bipolar disorder and major depressive disorder, despite prior marketing to the contrary.

In rare cases, gabapentin has been associated with an increased risk of suicidal thoughts or behaviors. Patients and their families should be aware of this risk and report any unusual mood or behavior changes to a healthcare provider immediately.

Yes, abruptly stopping gabapentin can lead to withdrawal symptoms, including heightened anxiety, irritability, restlessness, insomnia, and mood swings. A gradual tapering schedule, supervised by a doctor, is recommended to minimize these effects.

Gabapentin provides a more gradual and less potent calming effect compared to the rapid, sedative action of benzodiazepines like Xanax. Gabapentin also carries a lower risk of dependence than benzodiazepines, making it a potential alternative for long-term anxiety management.