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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. Typically, the starting dose of Gabapentin for bipolar disorder is 300 mg taken orally, two to three times daily. The dose may be gradually increased over time, up to a maximum dose of 1800 mg per day, as tolerated and as needed to achieve symptom control. 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- acute mania with gabapentin (at 3600 mg/day) mono-therapy in a 40-year-old man with DSM-IV bipolar I dis-order and alcohol dependence. Shaffer and Shaffer8 re-ported the positive response of 18 of 28 patients treated with adjunctive gabapentin; all patients were diagnosed with a type of bipolar disorder refractory to treatment Illness response was assessed using the Clinical Global Impression Scale modified for bipolar disorder (CGI-BP). A 'positive response' was operationalized as a CGI response of much or very much improved. Results: Fourteen of the 18 (78%) treated for hypomania or mania had a positive response to a dosage range of 600-3,600 mg/day. Patients with 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 Typically, your doctor will prescribe 300 mg once a day, usually in the evening, to start. The dose will then be increased every three to five days. Some people will take 600 mg/day, 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 to Gabapentin for Bipolar Disorder User Reviews Brand names: Neurontin, Gralise, Gabarone, Fanatrex. Gabapentin has an average rating of 8.5 out of 10 from a total of 138 reviews for the off-label treatment of Bipolar Disorder. 81% of reviewers reported a positive experience, while 9% reported a negative experience. Off-label gabapentin (Neurontin) got a bad rep when it missed the mark in bipolar disorder, but there may be something worth salvaging in this drug. Here, we weigh its pros and cons for anxiety, substance use disorders, sleep, pain, and hot flashes, and compare it to its underutilized cousin, pregabalin (Lyrica). 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. DSM-IV criteria for unipolar major depressive disorder, bipolar disorder type I, and bipolar disorder type II. The diagnosis of bipolar disorder, NOS, was made using DSM-IV criteria augmented by the recommended criteria of Akiskal,13 in order to assess possible effects of gaba-pentin on a broad definition of the bipolar spectrum. Indi- Despite previous marketing claims, there’s no evidence that gabapentin is a useful treatment for bipolar disorder. The best treatment for bipolar disorder is a combination of other medications, including mood stabilizers, anticonvulsants, and antipsychotics. - Responders had longer bipolar disorder illness duration (23.3 (12.2) vs. 12.9 (9.8)). - Final gabapentin dose was higher in non-responders (2085) than in responders (1425). - Gabapentin was generally well tolerated. Mild sedation was the most common adverse effect in 7 patients. Young et al., 1999 : Open-label trial (n = 37) 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. The mean dose of gabapentin was 1,310 mg/day. Conclusion: 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. 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. There is sufficient evidence to consider the use of gabapentin for social anxiety disorder and, potentially, severe panic disorder after other treatment options have failed. With safety, efficacy, and a proposed mechanism well-established for treating neuropathic pain and seizure, 2 – 5, 10 – 13, 16 numerous case reports and reviews suggest gabapentin’s potential efficacy as either monotherapy or adjunctive therapy in the treatment of bipolar disorder, depression, anxiety disorders, posttraumatic stress 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.
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