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The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2010 on the treatment of acute bipolar depression. The World Journal of Biological Psychiatry, Vol. 11, Issue. 2, p. 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. More specifically, can it prevent future episodes of mania and depression? Right now, there is no good evidence that gabapentin can be used for treating people with bipolar disorder. Researchers found that gabapentin does not help people with bipolar disorder. Learn more about the history of why some doctors prescribe gabapentin for bipolar as an adjunct therapy, even though there’s no evidence that it works for bipolar treatment or maintenance. is more gabapentin prescribed for bi-polar disorder than lamotrigine, even though there is little compelling evi-dence for gabapentin’s efficacy in bipolar disorder and the FDA has approved lamotrigine for the treat-ment of bipolar disorder.1,2 Thus, up to half of bipolar patients receiving combination therapy are given anti- Gabapentin for Bipolar Disorder User Reviews Brand names: Neurontin, Gralise, Gabarone, Fanatrex. Gabapentin has an average rating of 8.5 out of 10 from a total of 138 reviews for the off-label treatment of Bipolar Disorder. 81% of reviewers reported a positive experience, while 9% reported a negative experience. Of note is the difference in treatment efficacy noted by Erfurth et al.’s 1998 study that compared adjunctive gabapentin treatment with gabapentin monotherapy within the same time period . For the adjunctive group, all six patients had a significant decrease in their BMRS scores, while for the monotherapy group, four out of eight patients 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 due to heterogeneity in the study population, design and outcome measures. For the acute treatment of BD, our primary outcome was the efficacy of gabapentin or pregabalin as measured by the following: (i) number of hospital admissions during the study period, (ii) length of hospital admission, (iii) change on validated manic or depressive symptom rating scales from baseline, (iv) change on validated psychotic symptom A psychiatrist answers common questions about mood stabilizers for bipolar depression. Other medications, like topiramate (Topamax) or gabapentin (Neurontin), may be prescribed in some cases From the data presented, gabapentin cannot be recommended for treatment of bipolar disorder. Further studies are required to determine whether gabapentin has any role in the management of bipolar disorder. Gabapentin has less likely benefit adjunctively for bipolar disorder. Gabapentin has clearer efficacy for alcohol craving and withdrawal symptoms and may have a role in adjunctive treatment of opioid dependence. There is no clear evidence for gabapentin therapy in depression, PTSD prevention, OCD, or other types of substance abuse. 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 due to 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 treat 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). 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. 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 . At this time, concurrent carbamazepine and gabapentin treatment appears benign and may be reasonable in treating refractory bipolar disorder. Lamotrigine and gabapentin. Our search revealed no published data regarding the coadministration of lamotrigine and gabapentin in bipolar disorder. 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.
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