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

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...

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...

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...