Neurontin

Neurontin? Never heard of it? Neurontin is the brand name of the medication known as Gabapentin. A compound originally created to approximate the neurotransmitter gamma-aminobutyric acid (GABA for short), Gabapentin has several FDA approved medical uses and is also occasionally prescribed for bipolar disorder. While not a common medication, might be helpful to be familiar with it, as some doctors do suggest a trial of this medication when others have not been well tolerated or effective.

What is Neurontin Prescribed for?

Neurontin gained FDA approval for use with seizure disorders and other neurological conditions. Off label use, however has been common with this medication, and for several years during the 1990s Neurontin was a popular psychiatric medication suggested to be helpful in controlling manic episodes, anxiety, and obsessive compulsive disorder. However, this medication has fallen out of favor with the medical community, especially regarding its use in treating bipolar disorder, as further research indicated that it was not effective. In fact, studies paid for by the manufacturer suggested that Neurontin was no more effective than a placebo at reducing bipolar symptoms. This led to a lawsuit against the manufacturer for promoting this off label use despite its lack of effectiveness, and a sizable settlement was won.

Despite the negative media attention Neurontin’s makers earned, it is still prescribed for bipolar by some doctors and some people seem to do well on it.

What Does it Do?

As with most psychotropic medications, the specific mechanism by which it works has not been identified. However, research seems to indicate that Neurontin may stop new nerve synapses from forming. Just why or how this helps with neurological conditions, pain or mood disorders is not known. However, regarding bipolar disorder, it is reported that Neurontin helps with alleviating manic symptoms, and is also helpful if anxiety is present. Neurontin has not been found to be helpful in treating bipolar depression.

What are the Most Common Side Effects?

Neurontin is a more easily tolerated medication compared to many other psychotropic drugs. The side effects are fewer and generally less severe than ones reported for other mood stabilizers or antipsychotics. Most commonly reported are:

• Dizziness

• Daytime sleepiness

• Swelling due to water retention, especially in the hands and feet

• Stomach upset

Special Concerns

As with any of the medications used for epilepsy that are also prescribed for bipolar disorder, such as Depakote, Tegretol, Lamictal and Topomax, an increased risk of suicide has been correlated with Neurontin. Some antidepressants also carry this warning. Be sure to have a safety plan in place and share it with your partner or loved ones, before you begin taking any anticonvulsant or antidepressant. With any luck you will never need to put your safety plan into action, but once you are feeling suicidal, that is not the time to begin to figure out what to do.

Neurontin is not considered safe for use during pregnancy, but may still be prescribed if a careful examination of the options leaves you feeling that the benefits outweigh the risks.

Neurontin should not be stopped “cold turkey.” Be sure to discuss going off this medication with your doctor and comply with any reductions suggested.