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Quick Facts About Neurontin / Gabapentin

Bipolar Medications Library

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Updated June 08, 2012

Neurontin - generic name gabapentin - is an anticonvulsant) approved to treat epilepsy, and pain that remains after someone has had shingles, a disease related to chicken pox. Neurontin is also often prescribed off-label for use as a mood stabilizer for people who have bipolar disorder, and for the treatment of anxiety.

Neurontin carries the following warnings:

Antiepileptic drugs (AEDs), including Neurontin, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.

Other Notes About Neurontin:

  • Neurontin is also available in its generic form, gabapentin. Several manufacturers make prescription gabapentin pills.

  • Dosage adjustment and monitoring is necessary in patients with kidney problems.

  • If you use Maalox, do not take gabapentin at the same time. Gabapentin should be taken at least two hours after taking Maalox.

  • Pregnancy: animal studies have resulted in fetal death and birth defects. Neurontin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

  • Nursing: Gabapentin is excreted in breast milk. Risks to the infant are not known. Neurontin should be used in women who are nursing only if the benefits clearly outweigh the risks.

  • Children: Neurontin is not FDA approved for the treatment of bipolar disorder in either adults or children. It is approved to treat children aged 3 and over as an add-on medication for partial seizures.

  • The most common side effects of Neurontin are dizziness and sleepiness. The usual warning about not driving or operating heavy machinery at first applies. Unsteadiness in walking, uncontrolled eye movements, double vision and tremor are other common side effect. See Neurontin Side Effects.

  • In clinical trials, children given gabapentin were more likely than the control group to have viral infections and fevers.

  • If you are breaking a scored tablet to get the proper dose, use the second half of the tablet the next time you take it. A half-tablet not used within several days should be thrown away.

Neurontin Controversy

There is a great deal of controversy about Neurontin's effectiveness in treating bipolar disorder. A lawsuit was filed in 2002 claiming that manufacturer Parke-Davis had illegally marketed the drug for several off-label uses, including bipolar disorder. Included was documentation that at least one of Parke-Davis's own studies showed Neurontin not to be helpful for BP, and that these results were suppressed. In 2004 Pfizer Inc., which had acquired the parent company of Parke-Davis, paid $430 million in penalties after admitting that Neurontin had been marketed fraudulently for unapproved uses.

A recent review of the literature (Williams, 2009) regarding gabapentin as a mood stabilizer found no reports of studies meeting high-quality criteria. The results of those studies were mixed, but more than half were either neutral or negative about the effectiveness of gabapentin in treating BP.

Does This Mean You Shouldn't Take Neurontin?

Not necessarily. Some people do respond well to gabapentin as a mood stabilizer. Like any other medication, each person has to evaluate his or her response. If you find that Neurontin works well for you, with few or tolerable side effects, there is no reason to stop taking it.

Sources:

Neurontin Full Prescribing Information

Williams, JW Jr, Ranney L, Morgan LC, Whitener L. How reviews covered the unfolding scientific story of gabapentin for bipolar disorder. Gen Hosp Psychiatry 31(3)(2009): 279-287.

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