In what cases do you recommend the use of gabapentin for off-label use in alcohol use disorder?  

Often patients with AUD who decline first-line medication treatments, i.e., naltrexone or acamprosate, are more open to gabapentin when advised of its potential benefits for anxiety, mood, and sleep, as these are common issues that drive alcohol cravings and use. Flexible dose titrations starting wi...

The APA guidelines suggest gabapentin primarily for patients with moderate to severe alcohol use disorder (AUD) who aim to reduce alcohol intake or achieve abstinence, especially if they are intolerant or unresponsive to naltrexone and acamprosate. Additionally, gabapentin may be prescribed off-labe...

In addition to it being used as an off-label 5th line agent (naltrexone, acamprosate, disulfiram, and topiramate being considered first) for alcohol cravings if other options are contraindicated/unsuccessful, one can also consider gabapentin if treating co-morbid conditions in patients with AUD whic...

I sometimes use gabapentin in high-intensity outpatient BH if I think they might go into withdrawal or are already starting to stage, starting with 300-300-600. I start this as early as possible during the day, hoping to get two doses in before the program ends, check a visa, and send them home with...

The only time I have an issue with gabapentin is if the patient has a history of opiate substance use, then I won't prescribe due to the risk of OD when taking both. I am also hesitant to combine it with Suboxone.

Or drug shortages. In our VA system, we currently don't have access to acamprosate.