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Gabapentin isn’t usually used to treat anxiety alone. More often, it’s given to ease anxiety symptoms for someone who also has depression or bipolar disorder. (Anxiety is commonly 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. 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 Abstract Background: Gabapentin, a new anti-epileptic agent, has been anecdotally reported to be effective in the treatment of mania. We systematically assessed the response rate in bipolar patients being treated adjunctively with gabapentin for manic symptoms, depressive symptoms, or rapid cycling not responsive to standard treatments. 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. 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. There are now five medications with specific, FDA approval for acute bipolar depression. Evidence does not support the use of gabapentin for bipolar disorder, major depressive disorder (MDD), posttraumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), stimulant use disorder, or opioid withdrawal. 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. 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). Experts agree that gabapentin doesn’t work for bipolar disorder. Learn more about gabapentin and bipolar as well as what conditions it’s FDA approved to treat. For bipolar disorder, four double-blind RCTs investigating gabapentin, and no double-blind RCTs investigating pregabalin, were identified. A quantitative synthesis could not be performed Gabapentin can also be prescribed off-label, for uses that are not approved by the FDA, including in the treatment of bipolar disorder, anxiety disorders, treatment resistant depression, alcohol withdrawal, insomnia, posttraumatic stress disorder (PTSD), neuropathic pain, fibromyalgia, and migraines [2]. An abundance of open-label trials and case series exist on gabapentin’s use in bipolar disorder. While these data are less rigorous, they may be helpful with individual patient treatment (specific case comparison to similar specific clinical parameters), and review is warranted. 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 Explore gabapentin's role in mental health treatment, including its uses, benefits, and potential risks. Learn about dosage, effectiveness, and side effects. Gabapentin, a medication commonly used to treat seizures and nerve pain, has also been explored as a potential treatment for bipolar disorder. Research suggests that gabapentin may help alleviate symptoms of bipolar disorder, particularly in patients who have not responded to traditional treatments. What is Bipolar Disorder? 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 Gabapentin may help people with bipolar disorder in some ways by improving mental health symptoms like irritability, social withdrawal, and anxiety. It may also help with insomnia due to its sedative effects. Conclusion: Gabapentin was effective in the treatment of mania and hypomania in patients with bipolar and schizoaffective disorders. If confirmed in controlled studies, these findings suggest that gabapentin represents a well-tolerated, rapidly acting antimanic agent. Received Dec. 11, 1997; accepted July 20, 1998.
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