[okiedokie]

Hi Dr. W.,
I'd love to hear your thoughts about the off-label uses of Neurontin in treating anxiety and mood. What is an average dose? Why isn't it prescribed more often for anxiety instead of benzos?

Also, do you think having one's PMD prescribe psych meds is just as safe as if done by a psych? Do you think a psych should annually review meds or not necessary?
Thanks much,
Okie

[psisci]

Gabapentin and pregabalin can be quite effective for generalized anxiety. Doses vary alot from person to person, but I have seen people on up to 3000 mg of gabapentin and have no problems. Gabapentin is very safe as it does not interact with anything due to its renal metabolism. Having your PCP prescribe is safe, but probably not as effective as a psych. There is an art to psychopharm, so if your PCP prescribes alot of psychopharm he/she will get the hang of dosing, when to use what med etc... In my work in primary care sttings I co-prescribe with PCP's, and help teach them the art of psychopharm, and it works quite well.

[okiedokie]

Thank you very much. I'm a little concerned with my PCP prescribing my psych meds as I was the one who told her what to prescribe and she has kept me on the same meds/doses now for 4 years. I'm wondering if I should have psych review?

I was rx'd Neurontin 4600 mg. daily for inpatient benzo withdrawal. It worked great. Now take 800 bid but have been at this same dose for 4 years. I'm wondering if I still need to take it?

Happy Holidays to you. I think the service you provide here is very generous and I, for one, thank you.
Okie