Gabapentin and Anxiety: What to Know and When to Seek Help

Gabapentin can be associated with anxiety and other mood or behavior changes, and there are specific warning signs that should prompt you to contact a clinician right away. ^[1] Anxiety has also been reported after abruptly stopping gabapentin, so changes in dosing should be done carefully under medical guidance. ^[2]

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Is Anxiety a Side Effect of Gabapentin?

• Yes, anxiety can occur or worsen while taking gabapentin. Patient medication guides and prescribing information list “new or worse anxiety” among important mood and behavior changes to watch for. ^{[3] [4]}
• Behavioral and mood changes can happen even in people without prior mental health conditions. These changes are part of a broader safety advisory applied to antiepileptic medicines, including gabapentin. ^[3]
• Stopping gabapentin suddenly may also cause anxiety. Reports note anxiety and insomnia among the most frequent reactions after abrupt discontinuation. ^[2]

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Red‑Flag Symptoms That Need Prompt Medical Attention

If you notice any of the following while taking gabapentin, you should contact a healthcare professional urgently, and seek emergency care if symptoms are severe or involve safety risks:

• New or worsening anxiety, irritability, or depression. ^[1]
• Agitation or restlessness; panic attacks; trouble sleeping (insomnia). ^{[3] [1]}
• Aggressive, angry, or violent behavior; acting on dangerous impulses. ^{[3] [1]}
• Mania (unusually elevated, frenzied mood or excessive activity and talking). ^{[3] [1]}
• Any thoughts about wanting to hurt yourself or end your life. ^[1]
• Withdrawing from friends or family or other sudden changes in behavior or mood. ^[1]

These warnings are highlighted in consumer medication guides and official drug labeling because early recognition can reduce risk and help your clinician adjust the treatment safely. ^{[3] [1]}

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Practical Steps If Anxiety Appears

• Do not stop gabapentin abruptly. Sudden discontinuation can lead to anxiety and insomnia, among other withdrawal-like symptoms; tapering is usually recommended. ^[2]
• Call your clinician to discuss timing, dose, and possible interactions. Many symptoms improve with dose adjustment, slower titration, or transitioning to an alternative therapy. ^[3]
• Monitor patterns. Keep notes on when symptoms start, their severity, and any relationship to dose changes; this helps tailor your plan safely. ^[3]
• Seek urgent help for safety concerns. If you have suicidal thoughts, severe agitation, or dangerous impulses, get emergency care immediately. ^[1]

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Why These Warnings Exist

Regulatory agencies include mood and behavior change warnings on antiepileptic drugs to ensure proactive monitoring, even though large population studies have not consistently shown increased suicide attempts in all users of gabapentin. ^[5] Still, individual responses vary, and early action is advised when concerning symptoms appear. ^{[3] [1]}

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Avoid Abrupt Discontinuation

• Common reactions after stopping suddenly: Anxiety and insomnia are frequently reported when gabapentin is discontinued abruptly. ^[2]
• Safer approach: Work with your clinician on a gradual taper if discontinuation is needed to reduce withdrawal-like symptoms. ^[2]

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Summary Table: Key Warning Signs on Gabapentin

Category	Warning Sign	Action
Mood	New or worse anxiety, irritability, or depression	Contact clinician promptly
Behavior	Agitation, restlessness, aggressive or violent behavior, acting on dangerous impulses	Urgent medical attention
Anxiety Spectrum	Panic attacks, trouble sleeping (insomnia)	Contact clinician; consider dose review
Mania	Extreme increase in activity/talking, frenzied mood	Urgent evaluation
Safety	Thoughts of self-harm or suicide	Emergency care
Discontinuation	Anxiety and insomnia after abrupt stop	Taper under guidance

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Bottom Line

• Anxiety can be a side effect of gabapentin and a sign of withdrawal if the medication is stopped suddenly. ^{[3] [2]}
• Red‑flag symptoms such as panic attacks, agitation, mania, suicidal thoughts, or aggressive behavior require prompt medical attention. ^{[3] [1]}
• Work closely with your clinician to adjust dosing or taper safely to minimize risks. ^[2]