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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. 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. Accordingly, an extensive review on this subject has been carried out. 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. 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 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. 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 was 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. 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. 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. 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. 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. 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), 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. 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-
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