Xanax vs. Gabapentin: Which Is Right for You?

Because each medication works differently, the right choice depends on your unique health needs and should be made with guidance from your doctor or mental health provider. Choosing the right one can feel overwhelming, especially when you’re already dealing with anxiety. 

Understanding how Xanax and Gabapentin work can help you make the best, most informed decision.​ Continue reading to learn everything you need to know about Xanax vs. Gabapentin​. 

What Is Xanax?

Common uses

Your doctor might prescribe Xanax for:

• Acute anxiety
• Agoraphobia 
• Generalized anxiety disorder (GAD)
• Panic disorder
• Anxiety caused by depression*
• Short-term treatment of acute anxiety symptoms*
• Anxiety from specific situations, like flight anxiety or post-traumatic stress disorder (PTSD)*

*Off-label uses (meaning not FDA-approved for that specific use but known to help)

Pros of Xanax

One of the biggest benefits of Xanax is how fast the effects kick in. When you’re having a panic attack, you don’t have weeks or months to wait for relief. Xanax has a rapid onset that can be essential when you’re experiencing severe, acute anxiety. 

Cons and side effects

Despite the benefit of being fast-acting, there are some downsides to Xanax. The most common Xanax side effects are drowsiness and impaired memory, even if you don’t realize it right away. There’s also a risk of dependency when taken regularly for a long time. Additionally, some people find their anxiety is worse when Xanax wears off, which can increase the risk of overuse. 

Common side effects of Xanax include:

• Sedation
• Dependency risk
• Dizziness or feeling light-headed
• Memory issues
• Confusion
• Difficulty forming new memories 

Serious side effects are possible and require immediate medical assistance. Contact your doctor or go to the emergency room if you experience any of the following after taking Xanax:

• Weak or shallow breathing
• Hallucinations
• Double vision
• Seizures
• Engaging in risk-taking behavior
• Being extremely agitated
• Jaundice (a yellowing of the skin or eyes)
• Sudden bursts of energy or a decreased need for sleep
• Feeling light-headed to the point you might pass out
• Racing thoughts
• Becoming overly talkative out of nowhere

What Is Gabapentin?

Common uses

Your doctor might prescribe Gabapentin for:

• Nerve pain
• Postherpetic neuralgia (nerve pain following shingles)
• Seizures
• Hot flashes*
• Restless leg syndrome (RLS)
• Anxiety*
• Sleep disorders*
• Some types of mood disorders*

*Off-label uses (meaning not FDA-approved but known to help)

Pros of Gabapentin

Cons and side effects

Like any drug, there are negatives to Gabapentin. For example, it can make you feel tired or dizzy, and although less common than with other drugs, weight gain can occur. Finally, you may experience Gabapentin withdrawal symptoms if you suddenly stop your dose. Always consult your doctor before changing your dose or discontinuing. 

Common side effects of Gabapentin might include:

• Drowsiness
• Vision problems
• Nausea or vomiting
• Difficulty speaking
• Dizziness
• Swelling of the legs or feet
• Fever
• Headache
• Tremors 

Some people experience more serious side effects that require immediate medical assistance. Contact your doctor or go to the emergency room if you experience:

• Increased seizures
• Signs of an allergic reaction
• Problems with balance or muscle movement

Key Differences Between Xanax and Gabapentin

If you’re wondering if Gabapentin is like Xanax, it might help to look at a quick comparison chart:

Speed of onset

If you need something that works quickly, like within minutes, Xanax might be an ideal Gabapentin alternative, as Gabapentin can take longer to see the full benefits. 

How long does Gabapentin take to work, exactly? With this drug, you might not notice significant improvement immediately, but your baseline anxiety might decrease after several days or weeks of use. If you don’t see much improvement after a few weeks or a month, talk to your doctor about adjusting your dose or switching prescriptions altogether. 

Risk of dependence

Gabapentin is not technically a controlled substance, but many states have set regulatory standards. You can become dependent on it, even if the risk of developing an addiction is lower. 

Never stop taking either drug abruptly unless you’re under the guidance of a doctor or mental healthcare professional. They will help you come up with a safe and effective taper plan to come off your dose little by little, so your body has time to adjust without severe withdrawal symptoms.  

Use cases

Xanax is better for short-term, acute anxiety. If you experience panic attacks that make you feel helpless and you’re looking for a drug that works fast, Xanax can be a good option. 

Gabapentin is better suited if you have chronic anxiety or anxiety with comorbid nerve pain (meaning your pain exists alongside anxiety). It can also be a more appropriate Xanax alternative if addiction is a concern.

“Xanax is normally chosen when the anxiety is sudden or paralyzing. This is commonly taken before situations that are known to trigger anxiety for some including flying, crowded spaces or public speaking. Xanax works at the same receptors as alcohol and therefore must be given with caution to someone who has a history of substance dependence. Gabapentin is a better option for anxiety treatment for a patient who. has a substance dependence history. It is also more likely to be prescribed for persistent anxiety as opposed to sudden anxiety attacks.”

– Talkspace therapist Dr. Dion Metzger, MD

Which Medication Is Right for You?

Deciding on medication to treat anxiety, nerve pain, or any related condition isn’t something you’ll come to lightly. With your doctor, you’ll consider more than just your current symptoms. You’ll also look at your health history, goals for treatment, medication history, and more. 

Consider Xanax if:

• You have sudden, intense, severe anxiety or panic attacks and need rapid relief
• You’re looking for a short-term, as-needed solution, not a daily medication
• You haven’t had problems with addiction or substance misuse in the past

Consider Gabapentin if:

• Your anxiety is chronic and has lasted weeks or months at a time
• You’ve struggled with addiction or substance misuse in the past and want to avoid medications with a higher risk of dependency
• You want a long-term, consistent option for treatment
• You have nerve pain, sleep issues, or other conditions in addition to anxiety

Xanax is not intended for long-term or regular use in the treatment of anxiety. It serves as a short-term solution for acute symptoms. For ongoing management, a daily medication such as an SSRI or SNRI is typically preferred, as these work to prevent anxiety from occurring rather than simply providing temporary relief.

Talk to a Psychiatrist Before Starting Either Medication

Xanax and Gabapentin are only available by prescription for a reason. Never take either drug unless you’re under the supervision and guidance of a licensed psychiatrist or other medical professional. It’s critical that you’re honest with your doctor about your symptoms, needs, and history so you can get the safest, most effective treatment plan in place. 

“Xanax is not intended for long-term or regular use in the treatment of anxiety. It serves as a short-term solution for acute symptoms. For ongoing management, a daily medication such as an SSRI or SNRI is typically preferred, as these work to prevent anxiety from occurring rather than simply providing temporary relief.”

– Talkspace therapist Dr. Dion Metzger, MD

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Reach out today to get a prescription for Gabapentin online or find the right medication for your unique needs.