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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. While gabapentin is not currently FDA-approved for the treatment of OCD, there is growing interest in its potential as an alternative or adjunctive therapy for this condition. Several studies have explored the use of gabapentin in OCD, with mixed but promising results. 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 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. While adjuvant memantine to a standard medication with a selective serotonin-reuptake inhibitor (SSRI) appears to reduce OCD symptoms, the adjuvant effect of gabapentin is less certain. 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. OCD is a common and chronic anxiety disorder associated with considerable morbidity and socioeconomic burden. 3-6 Because many previous studies have demonstrated the clinical efficacy of selective serotonin reuptake inhibitors (SSRI) in treating OCD, 7 SSRI have been considered the first-line treatment for OCD. 8-10 However, approximately 40 Adding gabapentin to fluoxetine in the treatment of OCD seems to shorten the time to onset of fluoxetine's anti-obsessive effect without a significant increase in adverse effects. In order to accelerate the clinical response, co-administration of fluoxetine and gabapentin may be a preferable strateg Some anticonvulsant drugs (such as gabapentin [Neurontin] or pregabalin [Lyrica]), some blood pressure medications (such as propranolol), and some atypical antipsychotics (such as aripiprazole In a small, randomized, controlled trial involving patients with obsessive-compulsive disorder (OCD), Gabapentin was added to their treatment regimen alongside Fluoxetine. The study found some promise in accelerating the treatment response. Another study focused on breast cancer survivors experiencing nonspecific anxiety symptoms. The present pattern of results suggests that glutamatergic medications such as gabapentin and memantine adjuvant to a standard treatment with an SSRI have no additional positive impact on patients with OCD, as measured with the Y-BOCS. Additionally, side-effects were reported. Future studies should Gabapentin isn’t the main treatment option for anxiety, but it can be an effective alternative when other medications haven’t worked. Obsessive-Compulsive Disorder. Only 1 study has evaluated gabapentin use for obsessive-compulsive disorder (OCD). Onder et al 68 studied fluoxetine monotherapy versus fluoxetine with adjunctive gabapentin in controlling OCD symptoms. Forty patients were randomized (open-label) to fluoxetine 20 mg/d or fluoxetine 20 mg/d with gabapentin 600 mg/d. The interaction between glutamatergic and GABAergic systems has been considered to improve the symptoms of OCD, and gabapentin has been shown to be efficient in reducing the symptoms of anxiety; therefore, we thought that gabapentin might be useful in the treatment of OCD as add-on medication. Recent evidence of abnormal glutamate neurotransmission in OCD generated a series of trials evaluating glutamate modulators as augmentation agents for treatment-resistant OCD. N-acetylcysteine (NAC) has the greatest body of support. 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 This use of gabapentin for the treatment of anxiety is referred to as an off-label use, meaning there is limited data on its effectiveness to treat anxiety. Other off-label uses include treating alcohol withdrawal for alcohol use disorder and hot flashes associated with menopause. Gabapentin is not a typical medication for OCD, although it is often prescribed “off-label” if a medical provider deems it necessary. Thus, researchers have found that gabapentin can ease OCD symptoms in some people. vising against the combined use of gabapentin with central nervous system depressant (CNS-D) drugs, many of which are used in psychiatric treatment regimens (14 ). A range of short-term and long-term adverse outcomes can result from concomitant use of CNS-D drugs and gabapentin that jeop-ardize the previously touted favorable safety pro file Gabapentin has been approved by the United States (US) Food and Drug Administration (FDA) for postherpetic neuralgia and as adjunctive therapy for focal seizures. 1 However, a recent analysis of US physician office-based prescription practices between 2011 and 2016 found that less than one percent of gabapentin prescriptions are for such indications. 2 In 2020, gabapentin was reported to be
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