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A recent survey using the US-based TriNetX electronic health records network showed that gabapentin had been prescribed at least once in 13.6% of patients with bipolar disorder (BD), 11.5% with anxiety disorders, and 12.7% with insomnia disorder; for pregabalin, the figures were 2.9%, 2.6%, 3.0% respectively (PJH, unpublished observations). 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). 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. Multiple RCTs have shown gabapentin to be ineffective for bipolar disorder. There is insufficient evidence to recommend the use of gabapentin for MDD, GAD, PTSD, or OCD. There is sufficient evidence to consider the use of gabapentin for social anxiety disorder and, potentially, severe panic disorder after other treatment options have failed. For bipolar disorder, four double-blind RCTs investigating gabapentin, and no double-blind RCTs investigating pregabalin, were identified. A quantitative synthesis could not be 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. RESULTS. Bipolar Disorder. The randomized controlled trials 19 –21 investigating gabapentin for treating bipolar disorder indicate it is likely to be ineffective. Data interpretation is difficult: dosing varies by trial, gabapentin is used as both monotherapy and adjunctive therapy, patients have heterogeneous diagnoses, and primary outcomes differ between studies. 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 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. Prescribers wish that gabapentin had utility in bipolar disorder because gabapentin isn’t a P450 substrate, is renally excreted, and is generic and thus relatively affordable. Unfortunately, gabapentin does not demonstrate efficacy in randomized trials for bipolar disorder and current treatment guidelines do not emphasize its use. 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. Abstract. Despite its prevalence and disease burden, several chasms still exist with regard to the pharmacotherapy of bipolar disorder (BD). Polypharmacy is commonly encountered as a significant proportion of patients remain symptomatic, and the management of the depressive phase of the illness is a particular challenge. The results suggest that gabapentin may be of benefit to bipolar patients who only partially respond to other mood stabilizers. A favorable side-effect profile and rapid action make this drug an attractive choice as an adjunctive therapy. Gabapentin is a new adjunctive medication to antiseizure therapies. Introduction Gabapentin has been extensively prescribed off-label for psychiatric indications, with little established evidence of efficacy. Gabapentin and pregabalin, a very similar drug with the same mechanism of action, bind to a subunit of voltage-dependent calcium channels which are implicated in the aetiopathogenesis of bipolar disorder, anxiety and insomnia. This systematic review and Gabapentin for Bipolar Disorder Understanding Gabapentin’s Role. 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 Background: with increasing awareness of lithium's limitations, several new anticonvulsants had been tested for their mood stabilisation during recent years. Among the innovative third generation mood stabilizing anticonvulsants, gabapentin (GBP) seems to have a broad spectrum of efficacy, although no certain data are available as to its efficacy and use in clinical practice. Gabapentin: Gabapentin is indicated for postherpetic neuralgia and serves as adjunctive therapy for managing partial seizures (with or without secondary generalization) in adults and pediatric patients aged 3 or older. Gabapentin appears to have acute anti-manic and anti-depressant properties as an adjunctive agent for refractory bipolar illness. Prospective double-blind studies are needed to further delineate its acute efficacy when used as monotherapy and its prophylactic efficacy as monotherapy or in conjuction 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- Right now, there is no good evidence that gabapentin can be used for treating people with bipolar disorder. High-quality, randomized controlled studies found that gabapentin
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