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Gabapentin and topiramate are also anticonvulsants that may act as mood stabilizers, but they are usually given in addition to other medications. Lithium (lithium carbonate or lithium citrate) Lithium (Carbolith, Duralith, Lithane) is found in nature in some mineral waters and is also present in small amounts in the human body. 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 “Mood stabilizers work by eliminating the more extreme ends of these [rapid changes in mood], allowing you to function normally.” Mood stabilizers will not cure bipolar disorder, but they can Some research suggests that gabapentin might have mood-stabilizing properties, potentially helping with conditions like bipolar disorder. It’s like the medication is acting as an emotional shock absorber, smoothing out the highs and lows. American Psychological Association: Gabapentin has been “largely discredited as a mood stabilizer for bipolar disorder.” Depression and Bipolar Support Alliance: Gabapentin “was used frequently for treatment of bipolar disorder, but controlled studies found it was no more effective than a placebo.” A psychiatrist answers common questions about mood stabilizers for bipolar depression. Other medications, like topiramate (Topamax) or gabapentin (Neurontin), may be prescribed in some cases Gabapentin (Neurontin) is FDA approved to treat seizure disorder and nerve pain from shingles. But it’s also used off-label to treat many other conditions, including anxiety, nerve pain from diabetes, and hot flashes. Gabapentin may be effective for anxiety, but it’s usually not a first-choice medication for this use. If used as a mood stabilizer or anti-depressant, the dose is usually between 900 and 2,000 mg a day. But, it may also be increased for better results. 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. Currently, the most useful mood stabilizer combinations are the mixtures of anticonvulsants and lithium, particularly valproate plus lithium. Carbamazepine, lamotrigine, and gabapentin have also been added to lithium with apparent safety. This article reviews evidence-based psychiatric uses of gabapentin, along with associated risks. An extensive literature review was conducted, primarily of articles searchable in PubMed, relating to psychiatric uses, safety, and adverse effects of Benefits of Gabapentin and mood stabilizer for chronic pain. Reduced pain intensity: Gabapentin can help alleviate chronic pain, making it more manageable for individuals. Improved functionality: By reducing pain, Gabapentin and mood stabilizers can improve an individual’s ability to perform daily tasks without discomfort. 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. Gabapentin is currently being studied as a treatment for bipolar disorder, and there have been favorable reports regarding its potential as a mood stabilizer (82, 83). The advantages of gabapentin include the lack of interactions with other drugs in the cytochrome P450 system and the lack of protein binding ( 84 ). For 1 year, 13 patients received adjunctive gabapentin with standard mood stabilizers and 12 patients received adjunctive placebo. On the basis of the CGI-BP, gabapentin-treated patients showed significant improvement from baseline to month 12. Adjunctive therapy of gabapentin to stable doses of mood stabilizers or atypical antipsychotics, initiated at 300 mg at bedtime and increased by 300 mg every four nights until symptom relief or adverse effects were noted. Final GBP dose was clinically determined. Maximum dose 3600 mg per day in divided doses (range 600 mg to 3300 mg).
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