Can Gabapentin Lead to Reduced OCD Symptoms?

Living with obsessive-compulsive disorder (OCD) can be hard – really hard. The non-stop, unwanted intrusive thoughts, mental images, urges, fears (obsession), and/or repetitive rituals or routines (compulsions). The most common way to treat OCD is with therapy, specifically cognitive-behavioral therapy (CBT), or exposure-response prevention (ERP) therapy, a form of CBT. Other therapies may be recommended for OCD, such as individual therapy, couples/marital therapy, art therapy, music therapy, hypnotherapy, eye movement desensitization and reprocessing (EMDR) therapy, etc.

When therapy alone does not work for some reason, medication is usually prescribed. The most common medication is selective-serotonin reuptake inhibitors (SSRIs), although other medications like serotonin–norepinephrine reuptake inhibitors (SNRIs), beta-blockers, monoamine oxidase inhibitors (MAOIs), or antipsychotics may be prescribed when SSRIs are ineffective. When these more traditional medications are ineffective, or a person is struggling with treatment-resistant OCD, anticonvulsants, like gabapentin, is prescribed.

Gabapentin is not a typical medication for OCD, although it is often prescribed “off-label” if a medical provider deems it necessary. Thus, researchers have found that gabapentin can ease OCD symptoms in some people. If you are wondering if gabapentin could reduce your OCD symptoms, you are in luck because this blog will help you determine if gabapentin is the right OCD treatment for you.

What is Gabapentin?

Gabapentin, commonly referred to by the brand names: Neurontin, Gralise, or Horizant, is an anticonvulsant FDA-approved to treat mini seizures, treatment-resistant partial epilepsy, neuropathy or nerve pain from shingles, or restless leg syndrome (RLS). It is also used “off-label” to treat other conditions, such as migraines, fibromyalgia, addiction, hiccups, hyperhidrosis, alcohol or cocaine withdrawal, hot flashes, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), depression, or obsessive-compulsive disorder (OCD).

Although researchers are not exactly sure how gabapentin works, the general consensus is that it affects your nerves and boosts the amount of serotonin, a hormone/neurotransmitter, in your brain. A serotonin deficiency or imbalance is believed to trigger a variety of health conditions, such as nerve pain, seizures, headaches, depression, anxiety, and OCD.

Gabapentin appears to increase the amount of GABA in the brain by attaching to voltage-gated calcium channels that are responsible for nerve activity. Thus, this medication has the ability to “correct” abnormal brain activity, and reduce nerve pain, anxiety, depression, intrusive thoughts, urges, images, fears (obsessions), and repetitive behaviors (compulsions) in some people. Gabapentin is often used as an alternative to narcotics, antidepressants, and anti-anxiety drugs.

Are There Different Types of Gabapentin?

Yes, there are different types of gabapentin, such as:

• Neurontin is used to treat postherpetic nerve pain or shingles pain. This form of gabapentin can also be combined with other seizure medications designed to treat partial-onset seizures in patients over the age of 2 years old.
• Gralise is only used to treat postherpetic nerve pain or shingles pain. Therefore, this form of gabapentin should not be used for any other medical condition.
• Horizant is a type of gabapentin called “gabapentin enacarbil.” This medication is available as an extended-release tablet and is used to treat restless legs syndrome (RLS), and postherpetic nerve pain or shingles pain. 
• Generic gabapentin capsules are also available to treat postherpetic nerve pain or shingles pain. They are also commonly combined with partial-onset seizure therapy in children over the age of 2 years old.

What is The Recommended Dosage of Gabapentin for OCD?

The recommended dosage of gabapentin for anxious OCD sufferers ranges from 300mg to 3600mg, per day, depending on the severity of anxiety and OCD symptoms.

How Should Gabapentin Be Taken?

Gabapentin should be taken exactly as prescribed by your doctor. In other words, follow the directions on your prescription label, and do not take this medication in larger or smaller amounts, or for a longer amount of time than recommended. 

Listed below are other notes you should be aware of when taking any form or brand of gabapentin: 

• Gralise and Horizant should be taken with food. 
• Neurontin can be taken with or without food. 
• If you break a Neurontin tablet in half, take one half of it now, and the other half when it is time to take your next dose. Keep in mind that broken tablets should be taken within a few days. 
• Swallow capsules or tablets whole, and do not crush, chew, break, or open them.
• Carefully, measure liquid gabapentin with a dosing syringe. Do not use a kitchen spoon. 
• Do not abruptly stop taking this medicine, even if you feel okay. Suddenly stopping gabapentin could cause seizures. 
• Follow your doctor’s instructions when it comes to tapering your gabapentin dose or stopping it altogether. 
• If you have been diagnosed with epilepsy or if you have seizures, wear or carry medical identification on you to let others know you have this condition or may exhibit this symptom (seizures). 
• Gabapentin can cause abnormal medical tests, so alert your doctor or other medical staff that you are taking gabapentin.

When Should Gabapentin Be Taken?

If you have been prescribed a 1x-a-day dosage of gabapentin, it is recommended that you take this dose in the evening or at night. The reasoning behind this recommendation stems from the fatigue effect it can have on you. Supporters of gabapentin tout its ability to eliminate nightmares and promote sound sleep.

What Are the Side Effects of Gabapentin?

Like most, if not all medications, gabapentin can cause side effects, such as:

• An allergic reaction – i.e., hives, shortness of breath or breathing difficulties, a swollen face, lips, tongue, or throat
• Skin rash 
• Fever
• Swollen glands
• Muscle aches
• Headaches or migraines
• Extreme fatigue 
• Severe muscle weakness
• Abnormal bleeding or bruising
• Upper stomach pain
• Yellowing of your skin or eyes (jaundice)
• Mood or behavioral changes
• Anxiety
• Panic attacks
• Insomnia 
• Impulsivity 
• Irritability
• Agitation
• Hostility 
• Aggression 
• Restlessness
• Hyperactivity 
• Depression
• Suicidal ideation (thoughts or attempts)
• Thoughts of self-harm (i.e., cutting or burning oneself)

Gabapentin can also cause serious side effects, such as:

• Weak or shallow breathing
• Blue-colored skin, lips, fingers, or toes
• Mental confusion
• Extreme drowsiness
• Severe muscle weakness
• Balance or movement problems
• Unusual or involuntary eye movements
• Increased seizures

***Contact your doctor asap if you experience serious side effects or if the generalized side effects persist or worsen over time.

Is Gabapentin Addictive?

Yes, it can be. 

One of the most severe gabapentin side effects is the risk of developing a new addiction or worsening a current addiction. Even though gabapentin is not considered an opioid, benzodiazepine, or narcotic, it could still trigger a chemical dependency in an OCD sufferer, especially someone, who already has an addiction or someone, who is genetically predisposed to addiction. In these individuals, gabapentin could potentially lead to drug-seeking behaviors, or withdrawal symptoms once gabapentin is discontinued. 

Gabapentin can be so addictive for some people that it has become a “go-to” drug for drug addicts. The reason why gabapentin is so popular among drug addicts is that it can cause some users to feel “high” or euphoric – when taken at high dosages. People keep returning to this medication even if they do not need it because of the pleasurable sensations elicited by it. Gabapentin can act like a sedative or numbing agent in the brain and body, thereby easing emotional and/or physical distress and pain in some people. On the flip side, gabapentin can also lead to dissociative behaviors, which can trigger pleasurable feelings, resulting in addiction.

Can Gabapentin Ease OCD Symptoms?

According to a 2008 study, adding gabapentin to fluoxetine for the treatment of OCD may limit side effects and quicken the onset of fluoxetine’s anti-obsessive properties. Thus, researchers found that combining the two medications can accelerate the medicinal effects in the body, thereby, reducing OCD symptoms. 

Conversely, another study suggests that gabapentin therapy is ineffective in the prevention or treatment of depression, substance abuse, PTSD, or OCD. Therefore, more research is needed to definitely determine gabapentin’s true effectiveness in the treatment of OCD.

Similarly, a 2018 study found that adding gabapentin to medications, like SSRIs, to treat OCD did not yield positive results on OCD symptoms when measured with the Y-BOCS. Moreover, supplementing SSRIs OCD treatment with gabapentin increased the risk of side effects.

Similar to OCD, gabapentin has also shown promise when treating people with social anxiety. In fact, researchers have found that people who take this medication for their OCD symptoms have a high risk of experiencing flatulence, nausea, somnolence, dry mouth, dizziness, and reduced libido, but most also experience less social anxiety and fewer social phobias than those who do not take gabapentin.

Can Gabapentin Worsen OCD Symptoms?

Yes, some OCD sufferers may see an uptick in their OCD symptoms, especially their compulsive behaviors. Gabapentin can also cause mood fluctuations, and increased depression and anxiety, which can worsen OCD symptoms in some people. Withdrawing from gabapentin can also trigger mood disorders, moodiness, and other mental health conditions, like anxiety and suicidal ideation (thoughts and attempts). However, suicidal ideation is more likely to occur in children and young adults.

Can Gabapentin Cause Memory Problems?

There is no evidence that gabapentin can cause memory problems, which is significant because OCD can mimic memory issues. More specifically, OCD can cause a person to repeat actions over and over again until they feel satisfied and the thoughts or urges go away. This can look like cognitive decline or dementia, although it could be an early sign of these conditions – it does not have to be. 

In fact, most OCD sufferers are well aware of the repetition of their behaviors but are unable to stop doing them. In other words, repeating a behavior is not necessarily a sign of a memory lapse, rather it may be a compulsion based on an unwanted obsession. Although some OCD sufferers may experience slight confusion with the long-term use of gabapentin, studies do not suggest that gabapentin triggers or worsens memory problems in OCD sufferers.

What Do OCD Sufferers Think About Using Gabapentin for Their OCD Symptoms?

The best way to determine the effectiveness, safety, and benefits of a medication is to ask its users – gabapentin is no exception.

Listed below are real-life reviews from people who have taken gabapentin for their OCD symptoms: 

“I developed anorexia, PTSD, and OCD after a sexual assault. Gabapentin especially helped me with my OCD symptoms. When I would wake up in the morning, my mind would repeat the same thoughts over and over, and my mood swings were crazy. The thoughts just would not stop no matter what I tried. So, eventually, I started taking 1/2 of a gabapentin tablet under my tongue every morning with food. Now, my mind is quiet and serene. I feel so joyful and optimistic every day. I am also productive and motivated at work now. Gabapentin is truly a miracle drug.”

“I take gabapentin for OCD and anxiety. I have not noticed any side effects except maybe a little brain fog if I take an extra pill at night. I take 400mg 3x-a-day. I started with 100mg and worked up over time. I have been on gabapentin for almost two years. It has worked better than most things I have tried for my anxiety and OCD. My wife is a military vet, who also takes gabapentin for her PTSD anxiety. It seems to be working well for her as well.”

“I took gabapentin briefly for OCD. But it gave me severe brain zaps. I think it may have also caused my paresthesia (numbness/tingling) on my forehead and face. I do not know for sure that is the cause, but I did not have an issue with that until I started gabapentin. I have been off of it for over a year, and my paresthesia persists.”

“I was taking Gabapentin 300mg for OCD for 4 weeks, but then my doctor decided to increase my dosage to 1000mg. Is it normal to have nervousness, increased sweating, and headaches after increasing the gabapentin dosage? I was feeling good on 300mg and the side effects were subsiding. How long will it take to adjust to 1000mg? I was also put on 10mg of lisinopril for high blood pressure. The gabapentin is helping with my OCD-related insomnia and nightmares. I just want the side effects to go away.”

Final Thoughts

Although the standard OCD treatment medication is SSRIs, sometimes it does not work and other medications are tried. One such medication is gabapentin. Research is mixed at this time with some studies suggesting that gabapentin can be beneficial for people with OCD and other studies suggesting that it is not. Thus, the only way to know if this anticonvulsant could be right for your type of OCD is to discuss the pros and cons with your doctor. One benefit of taking gabapentin for OCD is that it can be combined with many natural remedies and self-help tools, like mindfulness meditation, hypnosis, and/or Impulse Therapy, an online OCD recovery treatment program. With the right OCD help, you can be free from the restraints of OCD.

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