Gabapentin's benefits in benzo withdrawal:
http://www.ncbi.nlm.nih.gov/pubmed/19485969
Gabapentin in reducing alcohol relapse
http://www.ncbi.nlm.nih.gov/pubmed/18052562
Gabapentin benefitting OCD
http://www.ncbi.nlm.nih.gov/pubmed/18297416
Letters to the Editor in AJP
http://ajp.psychiatryonline.org/cgi/content/full/155/7/992
Gabapentin benefits preoperative anxiety
http://www.anesthesia-analgesia.org/content/100/5/1394.full
Gabapentin shows benefits in panic disorder
http://journals.lww.com/psychopharm...trolled_Study_of_Gabapentin_Treatment.11.aspx
Gabapentin shows benefits with social anxiety
http://journals.lww.com/psychopharm...t_of_Social_Phobia_With_Gabapentin__A.10.aspx
I could go on but I think the point is given.
Most of the above links I provided are double-blinded placebo controlled studies.
I don't recommend giving it as a first line therapy. Why? Mostly because it's not the norm. I always give the conventional treatments first. E.g an SSRI. I do sometimes, however, give it with an SSRI because as we know the benefits of an SSRI could take weeks to take effect. This is usually in more severe cases where the person is suffering very severe anxiety in the here and now. I am also much more likely to give it out if the person is suffering from chronic pain and anxiety. There's plenty of data showing Gabapentin's benefits with pain.
I have given in out to one patient where several (Lexapro, Zoloft, Luvox, Paxil) SSRIs were tried and failed in the treatment of her panic disorder. SNRIs were tried as well, and both categories were also tried with Buspirone augmentation, and all the meds mentioned were tried at maximum dosages for at least one month. The person was placed on Neurontin and her panic attacks stopped. Again, this was after pretty much all the above failed. I didn't try some meds because I thought they'd be redundant (e.g. Lexapro was tried, so I skipped Citalopram---besides, she was suffering and had already gone throught he guinea pig phase for months while I tried other meds).
How do I give it out? I give it out as it's generally recommended for other uses. E.g. start at 300 mg QHS. Gradually increase from there but ask the patient how they are feeling with each increase. I've noticed some patients feel like a zombie from it with just the starting dose. Others at higher dosages. If they get the zombie feeling--stop it, or only give it at a dose lower than the "zombie" dose if it's having a benefit.
I also explain to the patient that Gapabentin is not the standard treatment, but that the standard treatment for treating anxiety in the here and now (remember SSRIs can take weeks to take effect)--e.g. a benzodiazapine, has a much higher likelihood of causing dependence and addiction. I only give out Gapapentin after I've explained that and the patient still wants to give it a try. If the person is suffering from an anxiety disorder, and I started the Neurontin with an antidepressant, I wean the person off of Neurontin after the SSRI starts to work.
As for people getting off of benzos who have a substance problem, most of them want something to help with the benzo withdrawal and cravings. They beg me for something, and there really isn't something that's FDA approved for such. I have had several of them tell me that after trying Neurontin, they feel much better. I put them on Neurontin for a few weeks to months, then wean them off the Neurontin. I stop the Neurontin if the patient tells me they feel no benefit from it--which is some of them.
The above was pretty much the only thing I got out of that previous psychiatrist who's patients I took over that seemed useful.
Hey, EVEN A BROKEN CLOCK IS RIGHT TWICE A DAY. I think that's the case here. That same psychiatrist also gave out Depakote to treat anxiety. I never tried that, never saw any benefit with Depakote and anxiety, and the patients given Depakote for anxiety said it never helped them. I've done lit searches to see if there was any evidenced-based reason to give Depakote for anxiety and I've never seen it.