Gabapentin Therapy in Psychiatric Disorders

Berlin, R; Butler, Paul; Perloff, Michael D.

doi:10.4088/pcc.15r01821

Cited by 47 publications

(53 citation statements)

References 98 publications

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“…However, a placebo‐controlled trial in panic disorder patients failed to distinguish gabapentin and placebo . As of 2015, there were no published randomized, controlled trials evaluating the efficacy of gabapentin in GAD …”

Section: Gabapentinoids In Anxiety Disordersmentioning

confidence: 99%

“…It is widely prescribed off‐label for diabetic neuropathy and other neuropathic pain conditions. Numerous other off‐label and investigational uses for gabapentin have been described, including alcohol dependence, bipolar disorder, posttraumatic stress disorder, essential tremor, and perioperative anxiety . Pregabalin, approved for clinical use in the United States in 2004, is indicated for postherpetic neuralgia and partial‐onset seizures, and for the treatment of diabetic neuropathy, fibromyalgia, and neuropathic pain associated with spinal cord injury.…”

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confidence: 99%

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Gabapentin and Pregabalin for the Treatment of Anxiety Disorders

Greenblatt

2018

Clinical Pharm in Drug Dev

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Section: Gabapentinoids In Anxiety Disordersmentioning

confidence: 99%

mentioning

confidence: 99%

Gabapentin and Pregabalin for the Treatment of Anxiety Disorders

Greenblatt

2018

Clinical Pharm in Drug Dev

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“…17 Other trials of gabapentin in anxiety have focused on preoperative anxiety and have mostly found gabapentin to be more effective than placebo. 11 Given the lack of evidence of efficacy of gabapentin in bipolar disorder and anxiety, it may be difficult to understand the widespread prescription of the drug for these off-licence indications. However, the pharmaceutical company which promoted gabapentin, Pfizer, has been fined in the USA for illegal promotion of gabapentin for unlicenced indications.…”

Section: It Wasmentioning

confidence: 99%

Biological rationale and potential clinical use of gabapentin and pregabalin in bipolar disorder, insomnia and anxiety: protocol for a systematic review and meta-analysis

et al. 2017

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IntroductionGabapentin has been extensively prescribed off-label for psychiatric indications, with little established evidence of efficacy. Gabapentin and pregabalin, a very similar drug with the same mechanism of action, bind to a subunit of voltage-dependent calcium channels which are implicated in the aetiopathogenesis of bipolar disorder, anxiety and insomnia. This systematic review and meta-analysis aims to collect and critically appraise all the available evidence about the efficacy and tolerability of gabapentin and pregabalin in the treatment of bipolar disorder, insomnia and anxiety.Methods and analysisWe will include all randomised controlled trials (RCTs) reported as double-blind and comparing gabapentin or pregabalin with placebo or any other active pharmacological treatment (any preparation, dose, frequency, route of delivery or setting) in patients with bipolar disorder, anxiety or insomnia. For consideration of adverse effects (tolerability), single-blind or open-label RCTs and non-randomised evidence will also be summarised. The main outcomes will be efficacy (measured as dichotomous and continuous outcome) and acceptability (proportion of patients who dropped out of the allocated treatment). Published and unpublished studies will be sought through relevant database searches, trial registries and websites; all reference selection and data extraction will be conducted by at least 2 independent reviewers. We will conduct a random-effects meta-analysis to synthesise all evidence for each outcome. Heterogeneity between studies will be investigated by the I2 statistic. Data from included studies will be entered into a funnel plot for investigation of small-study effects. No subgroup analysis will be undertaken, but we will carry out sensitivity analyses about combination treatment, psychiatric comorbidity, use of rescue medications and fixed versus random-effects model.Ethics and disseminationThis review does not require ethical approval. This protocol has been registered on PROSPERO (CRD42016041802). The results of the systematic review will be disseminated via publication in a peer-reviewed journal.

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“…These findings suggest that possible pathology of the reward circuitry in response to ethanol use can be remedied through potentiation of I h currents. Thus, while LTG is useful for treatment of bipolar disorder, the benefit of gabapentin seems limited to anxiety and alcohol dependence [270]. Further research is required to conclusively define a role for gabapentin and LTG in other psychiatric disorders.…”

Section: Therapeutic Potential Of Hcn Channelsmentioning

confidence: 99%

HCN Channel Targets for Novel Antidepressant Treatment

Han

2017

Neurotherapeutics

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Major depressive disorder (MDD) is a chronic and potentially life threatening illness that carries a staggering global burden. Characterized by depressed mood, MDD is often difficult to diagnose and treat owing to heterogeneity of syndrome and complex etiology. Contemporary antidepressant treatments are based on improved monoamine-based formulations from serendipitous discoveries made > 60 years ago. Novel antidepressant treatments are necessary, as roughly half of patients using available antidepressants do not see long-term remission of depressive symptoms. Current development of treatment options focuses on generating efficacious antidepressants, identifying depression-related neural substrates, and better understanding the pathophysiological mechanisms of depression. Recent insight into the brain's mesocorticolimbic circuitry from animal models of depression underscores the importance of ionic mechanisms in neuronal homeostasis and dysregulation, and substantial evidence highlights a potential role for ion channels in mediating depression-related excitability changes. In particular, hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are essential regulators of neuronal excitability. In this review, we describe seminal research on HCN channels in the prefrontal cortex and hippocampus in stress and depression-related behaviors, and highlight substantial evidence within the ventral tegmental area supporting the development of novel therapeutics targeting HCN channels in MDD. We argue that methods targeting the activity of reward-related brain areas have significant potential as superior treatments for depression.

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Gabapentin Therapy in Psychiatric Disorders

Abstract: Further research is required to better clarify the benefit of gabapentin in psychiatric disorders.

Cited by 47 publications

References 98 publications

Gabapentin and Pregabalin for the Treatment of Anxiety Disorders

Gabapentin and Pregabalin for the Treatment of Anxiety Disorders

Biological rationale and potential clinical use of gabapentin and pregabalin in bipolar disorder, insomnia and anxiety: protocol for a systematic review and meta-analysis

HCN Channel Targets for Novel Antidepressant Treatment

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