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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 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 gabapentinoids, gabapentin, and pregabalin, target the α2δ subunits of voltage-gated calcium channels. Initially licensed for pain and seizures, they have become widely prescribed drugs. Many of these uses are off-label for psychiatric Case series suggest benefit of adjunctive gabapentin for mood symptoms in bipolar disorder, though the existing randomized controlled trials do not support this finding. Gabapentin’s role in acute mania is equivocal, and limited data exist on its use as prophylaxis in 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- Neurontin has been studied as a potential treatment for bipolar disorder, particularly for patients who have not responded to traditional medications. Some research suggests that Neurontin may help stabilize mood and reduce symptoms of depression and anxiety. "I have bipolar disorder, chronic depression, and anxiety, and gabapentin has helped tremendously without the use of other narcotic medicines. Yeah, it makes you feel a little loopy for the first few weeks, but after that, it does a wonderful job calming the nerves. Abstract Context. Rising drug costs have increased focus on how new pharmaceuticals diffuse into the marketplace. The case of gabapentin use in bipolar disorder (BPD) provides an opportunity to study the roles of marketing, clinical evidence, and prior authorization (PA) policy on off-label medication use. 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. The gabapentinoids, gabapentin, and pregabalin, target the α<sub>2</sub>δ subunits of voltage-gated calcium channels. Initially licensed for pain and seizures, they have become widely prescribed drugs. Many of these uses are off-label for psychiatric indications, and there is increasing concern abou 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. Neurontin is sometimes prescribed off-label for the treatment of the following conditions: Bipolar disorder: Bipolar disorder is a mental condition that causes sudden and extreme changes, in mood, energy levels, and daily functioning. These moods can range from irritable and sad to happy and energetic with no warning. 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 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 The drugs gabapentin and pregabalin are sometimes prescribed for people with bipolar disorder or insomnia. Research found little evidence that they are effective. The drugs have side effects and can be addictive; the team calls for further trials. Gabapentin and pregabalin (collectively known as gabapentinoids) are licensed in the UK to treat pain and seizures. Gabapentin isn’t usually used to treat anxiety alone. More often, it’s given to ease anxiety symptoms for someone who also has depression or bipolar disorder. (Anxiety is commonly Upon initial FDA approval, off-label experimentation with gabapentin commenced for neuropathic pain, bipolar disorder, and migraine prophylaxis (6). The sustained upward trend in off-label prescribing of gabapentin is concerning, considering the minimal high-quality evidence for many off-label uses. 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.
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