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No, gabapentin should not replace antipsychotic medications as the primary treatment for psychosis. While it may be used off-label to help manage certain symptoms, it is not a substitute for antipsychotic medications, which are specifically designed to target the underlying causes of psychosis. Gabapentin is an antiepileptic drug that has been used successfully in the treatment of neuropathic pain. 1 It has also been studied as a potential mood stabilizer in bipolar disorder; however, it has not been found efficacious. 2 There are various reports where gabapentin is found efficacious in patients with schizophrenia for treatment Gabapentin is widely prescribed off label in medical practice, including psychiatry. The U.S. Food and Drug Administration (FDA) warned of risks associated with gabapentin combined with central nervous system depressant (CNS-D) drugs, which are commonly prescribed in psychiatric treatment. According to this report, gabapentin could induce psychotic symptoms in patients who have not even had a history of drug use or specific illnesses. 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 most common side effects of gabapentin include somnolence, ataxia, and fatigue. However, no studies have reported gabapentin induced psychotic disorder. Here, we report a patient on gabapentin with symptoms of delusional disorder. 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. 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. Gabapentin could be used successfully as an adjunct to novel antipsychotics in partially responsive schizophrenia. However, large controlled studies are needed to examine the effectiveness of gabapentin in psychotic disorders. Keywords: schizophrenia, refractory, adjunctive treatment, gabapentin, risperidone, olanzapine. Introduction Chouinard G, Beauclair L, Belanger MC. Gabapentin: Long-term antianxiety and hypnotic effects in psychiatric patients with comorbid anxiety-related disorders. Can J Psychiatry 1998;43:305. Gabapentin-induced paradoxical exacerbation of psychosis in a patient with schizophrenia Can J Psychiatry . 2002 Dec;47(10):975-6. doi: 10.1177/070674370204701017. 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. Five trials of second-generation antipsychotics for CUD with comorbid schizophrenia showed none better than any other. Conclusion: Further research is needed to confirm the efficacy of gabapentin for withdrawal and gabapentin and N-acetylcysteine for CUD and to develop new medications for all 3 cannabis-related disorders. Sleep deprivation disrupts prepulse inhibition and can be used as a psychosis model to evaluate effects of gabapentin.Objectives This study aimed to investigate behavioral effects of gabapentin in However, manipulations in mice that mimic the schizophrenia-associated reduction of the actin cytoskeleton regulatory protein Arp2/3 in PFC pyramidal cells result in a progressive loss of dendritic spines that is followed by other molecular and behavioral alterations seen in schizophrenia, including elevated subcortical dopamine levels and Because gabapentin can enhance the psychological effect of opioids, it has the potential to be abused and has contributed to drug overdose deaths. Drugs such as gabapentin have been linked in rare cases to an increased risk of suicidal thoughts or behaviors. This article presents the negative side effects of gabapentin such as psychotic and depressive symptoms, which occur shortly after its use. The use of gabapentin in mood disorders is discussed through these side effects. Conclusion: Gabapentin could be used successfully as an adjunct to novel antipsychotics in partially responsive schizophrenia. However, large controlled studies are needed to examine the effectiveness of gabapentin in psychotic disorders. Keywords: schizophrenia, refractory, adjunctive treatment, gabapentin, risperidone, olanzapine Ethosuximide, used to treat absence seizures, may cause confusion, sleep disturbances, aggressive behavior, depression, and, rarely, psychosis. Forced normalization with ethosuximide may cause behavioral abnormalities ( 4 ). 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.
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