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Issue: Most patients with a bipolar spectrum disorder are treated with 2 or more drugs in combinations that are sometimes rational and evidence-based and sometimes not. Gabapentin may help with some symptoms of bipolar disorder, but there’s limited evidence supporting its effectiveness, and it’s not FDA approved for bipolar. Unfortunately, gabapentin does not demonstrate efficacy in randomized trials for bipolar disorder and current treatment guidelines do not emphasize its use. Despite of the lack of evidence, reviews of gabapentin prescribing patterns in the United States show that this medication is still being used with alarming frequency for bipolar disorder. Key takeaways: Gabapentin is a medication that’s used to treat seizures, nerve pain from shingles, and restless leg syndrome. Despite previous marketing claims, there’s no evidence that gabapentin is a good treatment for bipolar disorder. The best treatment for bipolar disorder is therapy and a combination of other medications. These include mood stabilizers, anticonvulsants, and Conclusion Gabapentin may be a useful drug for the add-on treatment of bipolar patients with poor response to other mood stabilizers. Gabapentin may improve depressive residual symptoms such as irritability, social withdrawal or anxiety. These results should be confirmed in randomized clinical trials. Results: Gabapentin was moderately to mark-edly effective in 30% (15/50) of patients, with statistically nonsignificant differences between patients with bipolar disorder type I, bipolar dis-order type II and NOS, and unipolar major de-pressive disorder. 70% reported side effects, mainly sedation, with 16% of the total sample discontinuing treatment due to adverse events. Conclusion Bipolar disorder (BD) Four DB-RCTs investigating the efficacy of gabapentin in BD were identified. 101 patients were randomised to receive gabapentin, 81 to placebo, 30 to lamotrigine and 19 to Gabapentin, a relatively new anti-epileptic drug (AED), is emerging as a therapeutic option for treatment refractory and rapid-cycling bipolar illnesses. Pharmacotherapy for bipolar disorders traditionally involves valproate, carbamazapine, or lithium, drugs which are associated with numerous adverse effects. Conversely, gabapentin has an attractive pharmacokinetics profile and relatively few The gabapentinoids, gabapentin, and pregabalin, target the α<sub>2</sub>δ subunits of voltage-gated calcium channels. Initially licensed for pain and seizures, they have become widely prescribed drugs. Many of these uses are off-label for psychiatric indications, and there is increasing concern abou Two new anticonvulsants, lamotrigine and gabapentin, have been used increasingly for bipolar disorder in the past several years. Despite this array of options, bipolar disorder remains a difficult disorder to treat. Some subtypes, such as those characterized by rapid cycling or mixed episodes, have been especially resistant to lithium treatment. Gabapentin is a nerve pain medication and anticonvulsant that has proven to be effective for people who have hard-to-treat depression or other mood disorders. Gabapentin may be a useful drug for the add-on treatment of bipolar patients with poor response to other mood stabilizers. Gabapentin may improve depressive residual symptoms such as irritability, social withdrawal or anxiety. These results should be confirmed in randomized clinical trials. Clinical Points Gabapentin appears to have some benefit for anxiety disorders but failed to show benefit in bipolar disorder trials. In the individual patient with a mixed psychiatric disorder, benefits are most likely due to anxiolytic effects. Gabapentin has modest efficacy for alcohol craving and withdrawal symptoms and may have some benefit in opioid dependence as an adjunct therapy Reviews and ratings for Gabapentin when used in the treatment of bipolar disorder. 144 reviews submitted with a 8.5 average score. Keywords: bipolar disorder, psychopharmacology, gabapentinoids, gabapentin, pregabalin 1. Introduction Bipolar disorder (BD) is a debilitating mental illness that affects more than 1% of the world’s population [1]. Its lifetime prevalence in adults across 11 countries was estimated to be 0.4% [2]. The gabapentinoids, gabapentin, and pregabalin, target the α2δ subunits of voltage-gated calcium channels. Initially licensed for pain and seizures, they have become widely prescribed drugs. Many of these uses are off-label for psychiatric The drugs gabapentin and pregabalin are sometimes prescribed for people with bipolar disorder or insomnia. Research found little evidence that they are effective. The drugs have side effects and can be addictive; the team calls for further trials. Gabapentin and pregabalin (collectively known as gabapentinoids) are licensed in the UK to treat pain and seizures. This article reviews evidence-based psychiatric uses of gabapentin, along with associated risks. An extensive literature review was conducted, primarily of articles searchable in PubMed, relating to psychiatric uses, safety, and adverse effects of The use of gabapentin in bipolar disorder (BPD) treatment provides an informative case of off-label uptake and abandonment of a new medication. Gabapentin was patented by Warner-Lambert in 1977 and FDA-approved in December1993 for the adjunctive treatment of epilepsy and in 2002 for postherpetic neuralgia (see Appendix 1 for timeline). We identified 40 open-label studies on the use of GBP in at least 600 patients with bipolar disorder (BP), manic, depressed, or mixed episodes and unipolar depression and four controlled studies.
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