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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. Increasing the dosage of pregabalin in patients with focal epilepsy decreases the frequency of seizures and ameliorates symptoms of anxiety, depression and insomnia. Gabapentin can also be prescribed off-label, for uses that are not approved by the FDA, including in the treatment of bipolar disorder, anxiety disorders, treatment resistant depression, alcohol withdrawal, insomnia, posttraumatic stress disorder (PTSD), neuropathic pain, fibromyalgia, and migraines [2]. While it’s not typically a first-line treatment for depression, some patients with bipolar disorder have found relief from mood swings when gabapentin is added to their treatment regimen. It’s like adding a stabilizer to a wobbly table – it helps even things out. Gabapentin is a nerve pain medication and anticonvulsant that has proven to be effective for people who have hard-to-treat depression or other mood disorders. Gabapentin works by mimicking a neurotransmitter in the brain called GABA. GABA has a calming effect on the brain and impaired functioning of GABA has been linked to various mental health conditions such as panic disorder and depression. It’s important to note that the medication gabapentin isn’t a synthetic or lab-made form of GABA. 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 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. We conclude that there is moderate evidence of the efficacy of gabapentinoids in anxiety states, but minimal evidence in bipolar disorder and insomnia and they should be used for these disorders 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. In addition to being used to treat pain, gabapentin is used off label to treat anxiety, alcohol use disorder (AUD), alcohol withdrawal, depression, substance use disorders (SUDs), sleep problems, and more. However, the data to support these off-label uses of gabapentin are mixed, especially for long-term use. There is no clear evidence for gabapentin therapy in depression, PTSD prevention, OCD, or other types of substance abuse. Limitations of available data include variation in dosing between studies, gabapentin as monotherapy or adjunctive treatment, and differing primary outcomes between trials. A recent systematic review concluded that gabapentin for alcohol use disorder may be safe only as an adjuvant but not as a monotherapy and that there is insufficient evidence to support its use as a treatment for other substance dependencies or for depression, OCD, PTSD, and schizoaffective disorder . The largest proportion of off-label Gabapentin is primarily an anticonvulsant medication, yet its association with psychiatric side effects, including depression, has garnered attention. While classified as serious but uncommon, reports indicate that depression can be exacerbated in individuals with a history of psychological issues. While studies don’t typically show effectiveness for improving symptoms of depression, there is evidence that gabapentin may have some benefit for anxiety disorders. A rat study found that gabapentin produced behavioral changes suggestive of anxiolysis, or feelings of calmness. Gabapentin isn’t the main treatment option for anxiety, but it can be an effective alternative when other medications haven’t worked. However, the literature is limited and suggests that gabapentin is predominantly abused by patients with other substance use disorders, notably opioid use disorder [17–21]. The doses used when gabapentin is abused tend to be higher than 3000 mg/day [ 17 ]. Neurontin - also known as Gabapentin - is a drug that is sometimes prescribed to those who experience anxiety especially in situations where the anxiety is co-occurring with bipolar disorder. Although gabapentin was traditionally used to treat seizures, it is now sometimes used as a mood stabilizer for depression and bipolar disorder because it calms neurons in the brain, and it may be effective for anxiety too.
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