Gabapentin, also known as Neurontin, was initially approved for epilepsy treatment and is now used for chronic pain conditions. It can have serious side effects, including memory loss and suicidal behavior in children, and has been found to have little effect on bipolar disorder despite being prescribed for it. Pfizer admitted to exaggerating its effectiveness as a mood stabilizer.
Gabapentin may be better known by its brand name Neurontin®. It was developed by the pharmaceutical company Pfizer® and first approved for use by the Food and Drug Administration (FDA) in 1994. The drug’s initial uses were as a partial treatment for epilepsy, as it was used in combination with other antiepileptic drugs. It’s also now approved to treat some chronic pain conditions, including postherpetic neuralgia, pain that can occur for a long time usually after people have a case of shingles. Doctors may also prescribe gabapentin for migraine or chronic pain conditions, but arguably the drug’s most controversial use is in the treatment of bipolar disorder.
There are many strengths of gabapentin and it can often be prescribed in large doses, exceeding 1200 mg. It is not recommended for pregnant or nursing women because the effects on the fetus or nursing infants have not been significantly studied. Use in children should be carefully watched, as some children may develop memory loss, depression, hyperactivity, mood changes or difficulty concentrating. These symptoms in children require immediate contact with the prescriber. There are also some indications that gabapentin may increase the risk of suicidal behavior in children, adolescents, and young adults.
Other serious side effects that warrant immediate medical attention include sudden loss of coordination, irregular heartbeat, trouble breathing, persistent sore throat, swelling of the arms and legs, significant stomach pain, tremors or tremors, and bleeding or heavy bruising that has no clear cause. Most people will not experience these side effects, but they may experience other common ones that are not dangerous. These could include weight gain, dry mouth, drowsiness, dizziness, nausea, constipation, tiredness or vision changes. Many of these side effects are transient and will go away as people adjust to the medication, but if they become bothersome, people should notify their doctors.
Some drugs can interact with gabapentin. Some common ones include hydrocodone (Vicodin), most antacids, morphine, and naproxen sodium (Aleve®). Taking these medications does not necessarily mean that a person cannot also take gabapentin, but the dosages may need to be adjusted or the timing of taking these medications carefully.
There continues to be excellent research supporting the use of gabapentin for its FDA-approved treatments. Unfortunately, the off-label use of bipolar disorder, which was extremely common in the late 1990s and early 2000s, has proven to be a costly and unfortunate mistake. Pfizer® admitted that it exaggerated the results of studies it performed that demonstrated Neurontin’s effectiveness as a mood stabilizer.
Subsequent independent studies have found that gabapentin has little to no effect on mood. Several lawsuits have resulted from Pfizer’s deliberate misdirection, yet some doctors continue to prescribe the drug despite these findings. There may be evidence that a very small percentage of patients find some benefit from this drug as an add-on therapy for bipolar disorder, but there is little evidence that this drug should be viewed as a first or even second-line treatment for the condition.
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