With this post, we continue our biweekly series on medications used to treat bipolar disorder and related symptoms. This week, we focus the spotlight on Neurontin (gabapentin) – an anti-seizure/anticonvulsant medication that has mixed results in preventing mania and controlling anxiety. Following are some key facts about Neurontin:
One of the primary uses of Neurontin is to treat pain – specifically neuropathic pain (pain related to the nerves). It is also used, off label, in the treatment of migraines.
Although Neurontin’s side effects are typically few and mild, side effects most often reported include the following:
One major disadvantage of Neurontin is that you need to take it up to four times a day, compared to twice a day for other anti-seizure medications.
There are no blood tests or blood levels to monitor when taking Neurontin. Doses can run quite high – up to 1200 mg per day – but higher doses means higher risk of side effects.
I do not use Neurontin much at all – I don’t prescribe it for mood episodes or managing bipolar disorder. I have some patients who have been on it for a long time, and they feel strongly that it helps to control their anxiety. It is generally very well tolerated, though, so I think it gets used a lot because it is thought of as low risk of harm, although I also think that for psychiatric purposes its potential benefits are low, as well.
Caution: Never stop taking any medication cold turkey, especially an anti-seizure medication. Withdrawing an anti-seizure medication too quickly can actually cause seizures. Always consult your doctor before you stop or decrease your medication.
If you’ve taken Neurontin for bipolar disorder or are a doctor who has prescribed it, please share your experiences, insights, and observations.
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From Psych Central's :
Mood Stabilizers for Bipolar Disorder - Psych Central (January 14, 2009)
I have been diagnosed as Bipolar II and at the time I had been taking Neurontin for pain. Not regularly, more sporadically. In the meantime we discovered that I was highly med sensitive when it came to phsych drugs and I had been through probably 8 or 9 and rejected them when I finally begged my pdoc to let me just use the Neurontin because I had noticed a huge beneficial mood change when I took it. I did some research and found that it had been used and I didn’t have any problem with taking it like I did with many of the other meds. She wouldn’t let me because the information was just to iffy as she put it. So I had to take a psych med break because we had been going back to back on new meds for so long and I wound up taking nothing for a while. My mother who also suffers from depression and neuropathy takes Neurontin for her pain and it helps her for both problems immensely.
I did augment my Depakote with Neurontin at one point, for 2-3 months. In my personal experience, not only did it not help, it provided no help at best and increased aggression at the worst.
I did Google it at that point, and the anecdotal evidence on the Internet seems to be that a) the manufacturer is marketing it as off-label for everything from anxiety to xenophobia (couldn’t think of a z- problem, sorry) and that b) it works for some people and not for others, possibly a lot of not others (but you can’t make negative inferences, of course).
Just my .02, but I’m suspicious of anything more than placebo effectiveness for many ‘off-label’ uses.
I am BP1 with manic/dysphoric cycling about 4 x a year, my worst months being the spring and summer. I was on Lamictal for 7 months but stopped when it induced depression.
After a recent visit with my pdoc, and a plea to forgo the Lamictal, (the withdrawal was unpleasant, and I experienced hair loss and textural changes) he prescribed Neurontin with trepidation. He said he had a similar case with another woman who was mainly hypomanic/manic with mixed dysphoric symptoms and who cycled 4x or so a year. He said if it was going to work it would work right away.
I’ve read all of the mixed reviews regarding this drug. But I have to say that I am one of those people who have benefited from its effects at this point.
For what it’s worth, treating BP is highly individualized, and oftentimes treatment resistant. Therefore,randomized clinical trials are a poor benchmark for clinical effectiveness. This is why I think you still see pdocs prescribing it despite all of the ‘evidence’ otherwise.
I was put on Neurontin as a substitute for Benzo’s when in rehab so that I wouldn’t be on anything addictive. This was to treat my anxiety along with Lexapro to treat my depression. For me it was the first thing that worked well. After a year on a fair dose of it, I noticed that my anxiety and depression were culminating into manic episodes. After being diagnosed BP1, I was then placed on Stavzor gel caps (that didnt work on their own which I found out the hard way). Neurontin was added back into the mix with Seroquel, Cymbalta, Stavzor, and Synthroid for my thyroid problem. So now I am at least 30 pounds over weight. And, yes, my thyroid is and has been stable for a year. Topomax made me practically pychotic. What can I do to lose this weight? Im planning to get into a kick-boxing class but having this extra weight is really hard for me since I am not accustomed to being out of shape. Im a mother of two small children so I cant be too out of it. Thanks for any advice you can toss my way.
…I dont want to feel that this is part of the “sentence” for having bipolar disorder.
Thank You.
-S
I’ve got say I think Neurontin is an evil drug. I was on it for years and it delayed my diagnosis of BP II for several years, while I spent time in and out of hospitals, with numerous suicide attempts. I would love to sue the makers of neurontin because when I was on it, the psychs I saw kept saying “Well she’s on a mood stabilizer, so she can’t be bipolar.” Years of my life wasted because of this drug. I think it is a nonsense drug, and there’s growing evidence of it being completely ineffective, but meanwhile they put people on thousands of milligrams of it. I would love to have those years back that I missed because this drug acted like a red herring. I’m at least glad you guys have questioned the efficacy of this medicine– it’s about time someone did.
I’m Bipolar II, and I regularly cycle once a month, but with random switches to mixed states thrown in between. I often get irritable and angry/anxious due to my sudden, dysphoric manias that can last from hours to days.
Neurontin has helped my anxiety and depression significantly, and has helped with my insomnia. The little aches and pains that manifest during depressive periods are better too. I felt kind of “high” and hypomanic/euphoric for a couple weeks initially, but now I don’t notice any side effects. Skipping a dose by accident will make me itchy, weirdly enough, and a little anxious but not much else. Very safe med too.
I am on depakote and on Pherphenazine -Trilafon
I am on Lithium Er 450 and i am on buspar for anxiety .
So i want to try Lamictal OR Neurontin .
I have been bipolar and schizo effective for a long time and found out a couple several years ago.
So i hope this works out for me i just saw my doctor today my psychiatrist.
So i am doing research on this today.
Kaitlin
I was on Neurontin for chronic back pain. I had a friend that thought after 33 years, I was bi-polar. I had been on different anti-depressants, but they just made me feel nothing. She suggested I triple my Neurontin, I had nothing to lose since I had no side effects. Within two weeks, I had my old life back. It was a miracle drug for me. I take 2100mg. I\’m not sure if that\’s too much or just right. I may try to taper down a little and see if it makes any difference. I had no idea I was Bi-polar. I have no side effects. It\’s like taking vitamins for me. I have much less back pain as well. I have done a lot of research on it. I am on the right track.
I am bipolar II,rapid cyling-I can be only stable for 3 months in a year rest of it passing with shifts of depression,hypomania,mixed episodes and I also have ultradian cycles.I am on lamictal and depakene and have been added neurontin about a month ago for sleep.Before neurontin my sleep was terrible but now I can sleep very well and have no drowsiness in the morning.It also stopped my restless leg symptoms.Recently I had a mixed episode.I do not know if it is triggered because of neurontin.Time will show if it is improving my cycles as it improved my sleep.
I started neurontin for shingles pain 4 weeks ago. Within 1/2 hour I noticed a rapid improvement of my mood. I have tried many anti depressants and found I cannot tolerate them. My depression has lifted and I am me again!!! So far5 this is working great.
I take gabapentin 600mg splitting it 300 in the am and 300 before bed. I cannot sleep without it anymore. Honestly it makes me relaxed but I can’t say it has helped my mood swings. I also take 150mg of lamictal every morning which does the job. The gabapentin eases me and helps the fidgetyness I get sometimes,
I was prescribed Neurontin for seizures after a head injury a few years ago, and then more recently for epicondylitis at the elbow. A side effect of this drug was an improvement in my mood. I am 47 yrs old and have been diagnosed with mild BPII but refused treatment and meds because of horrible side effects. My immediate family refuses to believe that I am BP. I hide it well. However, my live-in boyfriend believes I am BP, and says that Neurontin is my “happy pill.” I ran out once and it got so bad that he begged me to start taking it again. Is it possible that the Neurontin has a positive affect on my mood?
MY BOYFRIEND WENT THE DR TODAY. HE WAS PRESCRIBED NEURONTIN, THE DR TOLD HIM TO FIND HIS DOSE, THE BST THAT WORKS WITH HIM.. SO I AM CROSSING MY FINGERS IN HOPES THAT THIS MED WORKS FOR HISAKE AND MINE AS WELL