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But since it’s been available, gabapentin has also been used off-label in psychiatry to treat patients with treatment-resistant mood and anxiety disorders as well as alcohol-withdrawal and Objective: Gabapentin (GBP) is an anticonvulsant medication that is also used to treat restless legs syndrome (RLS) and posttherapeutic neuralgia. GBP is commonly prescribed off-label for psychiatric disorders despite the lack of strong evidence. concomitant use of CNS-D drugs and gabapentin that jeop-ardize the previously touted favorable safety pro file of gaba-pentin (e.g., breathing problems, sedation, and respiratory arrest) (15, 16). There is a clear need to better understand off-label gabapentin use for psychiatric conditions in order This study examined off-label use of gabapentin for psychiatric indications and its concomitant use with CNS-D prescription drugs in a nationally representative sample of ambulatory care office visits. Less than 1% of outpatient gabapentin use was for FDA-approved indications. An initial bibliographic reference search for gabapentin use in psychiatric disorders was performed in PubMed and Ovid MEDLINE from January 1, 1983 (gabapentin’s appearance in medical research literature), to October 1, 2014 with no language restrictions. There are actions psychiatrists can take to reduce the use of gabapentin: Educate patients: Engaging in open and honest discussions with patients about the risks and benefits of gabapentin is essential. Patients should be made aware of the potential for abuse, dependence, and overdose. The next step was to read all of this article’s references. 2-6 Surprisingly, all 5 references focused on the relationship of gabapentin with the use of opioids or in the treatment of pain, with no mention of the common off-label use of gabapentin in various psychiatric disorders such as anxiety and insomnia. Hence, I embarked on a literature The use of gabapentin in panic disorder and OCD was unable to demonstrate efficacy compared with placebo, and the use of gabapentin to prevent PTSD development was also not effective. 21 However, 2 small studies assessed gabapentin in the treatment of PTSD, and although results were largely based on subjective reporting, there were consistent al is necessary. Gabapentin, an anxiolytic drug that is also used off-label to treat alcohol withdrawal, is a potential candidate for modulating benzodiazepine withdrawal. Using electronic records from a large inpatient psychiatric facility, a retrospective study of 172 patients presenting with benzodiazepine withdrawal was conducted to determine if the coincidental use of gabapentin for other Objective: Gabapentin is commonly used off-label in the treatment of psychiatric disorders with success, failure, and controversy. A systematic review of the literature was performed to elucidate the evidence for clinical benefit of gabapentin in psychiatric disorders. 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 GBP has shown to be safe and effective in the treatment of alcohol dependence. However, the literature suggests that GBP is effective as an adjunctive medication rather than a monotherapy. More clinical trials with larger patient populations are needed to support gabapentin's off-label use in psychiatric disorders and substance use disorders. Another study published in the Archives of General Psychiatry examined the use of gabapentin as an adjunctive treatment for bipolar disorder and found that it was effective in reducing manic symptoms. Despite these positive findings, it is important to note that gabapentin is not approved by the FDA for the treatment of psychiatric disorders. Gabapentin is commonly used off-label in the treatment of psychiatric disorders with success, failure, and controversy. A systematic review of the literature was performed to elucidate the evidence for clinical benefit of gabapentin in psychiatric disorders. While gabapentin is frequently used in practice for a wide array of psychiatric diagnoses, its use is evidence-based for only a few indications. 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. Today, gabapentin is frequently prescribed off-label for various mental health conditions, joining the ranks of other mood-stabilizing medications like lamotrigine, which has shown promise in treating bipolar disorder and depression. The growing interest in gabapentin for psychiatric conditions isn’t just a passing fad. Objective: This article reviews evidence-based psychiatric uses of gabapentin, along with associated risks. Method of Research: An extensive literature review was conducted, primarily of articles searchable in PubMed, relating to psychiatric uses, safety, and adverse effects of gabapentin. Results: Evidence supports gabapentin as a treatment for alcohol withdrawal and alcohol use disorder More clinical trials with larger patient populations are needed to support gabapentin’s off-label use in psychiatric disorders and substance use disorders. It is worth noting that numerous clinical studies that are discussed in this review are open-label trials, which are inherently less rigorously analyzed. High concomitant use of CNS-D drugs and off-label gabapentin for psychiatric diagnoses underlines the need for improved communication about safety. In this nationally representative sample, <1% of outpatient gabapentin use was for approved indications. We conducted a systematic review and meta-analysis of the evidence for three of their common psychiatric uses: bipolar disorder, anxiety, and insomnia. Fifty-five double-blind
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