I think they go slowly because too much gabapentin (in my experience) caused grogginess, dizziness, confusion, visual issues, slurred speech, etc. When that happened I was put on a lot at once because of severe akathesia.

Later I was put on more during a different IP stay and they went much more slowly.

But even 100 mg PRN is really calming when I need it. The pdoc IP told me it works on receptors similar to klonopin so has that boost without being a benzo. Of course now they are concerned about gabapentin potentially being abused so that may not be such a good thing. My pdoc won't let me take nearly what the IP doctor did (but I don't need that much anyway now; then I was coming off 1200 mg of Seroquel in about a week while titrating up on clozapine).