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Gabapentin enjoys a wide spectrum of psychopharmacological and neuropharmacological indications. Curiously, we found only a single article on the efficacy of gabapentin for treating neuroleptic-induced akathisia [Pfeffer et al. 2005]. This is counterintuitive on theoretical and clinical grounds. Theoretically, gabapentin enhances the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that would be predicted to suppress the abnormal involuntary movements of akathisia. Clinically, gabapentin carries US Food and Drug Administration approval for restless legs syndrome (RLS), a neurological disorder. RLS and neuroleptic-induced akathisia are not identical conditions, but they are probably related, so one wonders why the efficacy of gabapentin has not been more thoroughly investigated in the latter disorder. The purpose of the present article is to investigate the efficacy of gabapentin for treating neuroleptic-induced akathisia in a private-practice setting. The patients' anonymity was carefully protected and the study was performed with informed consent and pursuant to all guidelines for study with human subjects as required by the institutions with which the authors are affiliated. Methods and results Case 1 The patient is a 64-year-old man with a lifelong history of generalized anxiety disorder (GAD), panic disorder with agoraphobia, severe insomnia, and mild bipolar disorder marked by irritability and paradoxical depression in response to tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAOIs). He has been under the care of the first author for 7 years, consisting of weekly, 1-hour psychopharmacology/insight-orientated psychotherapy sessions. Over the years the patient has been prescribed most classes of psychotropic drugs. It is worth noting that high doses of psychotropic drugs were required to elicit a satisfactory therapeutic

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