Gabapentin vs. Xanax (alprazolam) for Anxiety & Panic Disorders

What’s the difference between gabapentin and Xanax?

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?

Gabapentin

The most common side effects of gabapentin are:

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.

Xanax

The most common side effects of Xanax taken at lower doses are:

  • Drowsiness
  • Fatigue

Other side effects include:

  • Memory problems
  • Speech problems
  • Constipation
  • 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

Gabapentin is available as:

  • Capsules: 100, 300, and 400 mg.
  • Tablets: 100, 300, 400, 600, and 800 mg.
  • Solution: 250 mg/5 ml

Xanax

  • 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.




QUESTION

Panic attacks are repeated attacks of fear that can last for several minutes.
See Answer

What drugs interact with gabapentin and Xanax?

Gabapentin

  • 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.

Xanax

Are gabapentin and Xanax safe to use while pregnant or breastfeeding?

Gabapentin

  • 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.

Xanax

  • 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.

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