What’s the difference between gabapentin and Xanax?
- Gabapentin and Xanax (alprazolam) are used to treat anxiety.
- A difference is that gabapentin is primarily an anti-seizure (anticonvulsant) drug used for preventing seizures and for treating post-herpetic neuralgia, the pain that follows an episode of shingles. Gabapentin is used off-label to treat anxiety. Xanax belongs to a different drug class called benzodiazepines, and is used primarily to treat anxiety disorders and panic attacks.
- Brand names for gabapentin include Neurontin, Horizant, and Gralise.
- Side effects of gabapentin and Xanax that are similar include drowsiness, fatigue, and memory problems or memory loss.
- Side effects of gabapentin that are different from Xanax include dizziness, sleepiness, loss of control of bodily movements, fluid retention, hostility, nausea, vomiting, difficulty speaking, jerky movements, unusual eye movements, double vision, tremors, and unsteadiness.
- Side effects of gabapentin that are different from Xanax include speech problems, constipation, changes in weight, and addiction (dependency).
- Suddenly stopping Xanax after prolonged use can lead to withdrawal symptoms including insomnia, headaches, nausea, vomiting, lightheadedness, sweating, anxiety, fatigue, and seizures.
What are gabapentin and Xanax?
Gabapentin is an anti-seizure (anticonvulsant) drug that is also used for treating post-herpetic neuralgia, the pain that follows an episode of shingles. Other off-label uses for gabapentin include anxiety, alcohol withdrawal, cocaine withdrawal, hiccups, restless leg syndrome, hyperhidrosis, headaches, diabetic neuropathy, hot flashes, and fibromyalgia.
Xanax (alprazolam) is a benzodiazepine used for the treatment of anxiety disorders and panic attacks. Other benzodiazepines include diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others.
What are the side effects of gabapentin vs. Xanax?
The most common side effects of gabapentin are:
- Fluid retention (edema)
- Difficulty speaking
- Jerky movements
- Unusual eye movements
- Double vision
- Memory loss
Other adverse effects and serious side effects associated with gabapentin include:
Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.
The most common side effects of Xanax taken at lower doses are:
Other side effects include:
- Memory problems
- Speech problems
- Changes in weight
- Addiction (dependency)
Addiction is more likely to occur at high doses given over prolonged periods of time. Abrupt discontinuation of alprazolam after prolonged use can lead to symptoms of withdrawal such as:
Seizures can occur in more severe cases of withdrawal. Consequently, patients on alprazolam for extended periods of time should slowly taper the medication under a doctor's supervision rather than abruptly stopping the medication.
What is the dosage of gabapentin vs. Xanax?
Gabapentin is available as:
- Capsules: 100, 300, and 400 mg.
- Tablets: 100, 300, 400, 600, and 800 mg.
- Solution: 250 mg/5 ml
- The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.
- The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily.
- The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.
- Alprazolam may be taken with or without food.
Panic attacks are repeated attacks of fear that can last for several minutes.
What drugs interact with gabapentin and Xanax?
- Antacids reduce the concentration of gabapentin in blood. Therefore, gabapentin should be administered 2 hours or more after taking antacids.
- Morphine significantly increases blood concentrations of gabapentin and may increase central nervous system-related adverse events associated with gabapentin.
- Ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone (Serzone), cimetidine (Tagamet), and fluvoxamine (Luvox) increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam.
- Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.
- Carbamazepine and rifampin reduce the effect of alprazolam by increasing metabolism and elimination of alprazolam in the liver.
Are gabapentin and Xanax safe to use while pregnant or breastfeeding?
- Doctors do not know the safety of gabapentin during pregnancy.
- Gabapentin is secreted in human breast milk; therefore, if you are pregnant you should only use this medication if the benefits outweigh the unknown risk to the fetus.
- Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy.
- Alprazolam is excreted in breast milk and can affect nursing infants. Therefore, it should not be used by women who are nursing.