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Gabapentin Could Be Effective in Mild to Moderate Bipolar Depression

Results of a 12-week open pilot study suggest that gabapentin might be effective as adjunctive therapy in patients with mild to moderate bipolar depression.

Investigators from Stanford University School of Medicine in Stanford, California, United States, report the drug was effective and well tolerated in 22 depressed outpatients with bipolar disorder. However, they state that the results must be viewed with caution and that randomised, controlled studies are warranted.

Previous controlled studies indicated gabapentin was ineffective as primary treatment for mania or treatment-resistant rapid cycling.

The current study enrolled 10 women and 12 men, mean age 38.4 years, who were being treated with stable doses of mood stabilisers or atypical antipsychotics. The mean duration of their illness was 18.6 years and the current depressive episode had lasted a mean of 18 weeks. Ten patients had been diagnosed as bipolar I, and 12 were bipolar II.

Results show Hamilton Depression Rating Scale (HDRS) ratings decreased by 53 percent overall after 12 weeks of treatment with gabapentin at a mean dose of 1,725 mg/day added to stable doses of mood stabilizers or atypical antipsychotics (p<0.0001). There was moderate to marked improvement in 12 patients (55 percent), with HDRS ratings decreasing 78 percent (p<0.0001). Eight patients (36 percent) achieved disease remission.

Response was observed in 10 of 13 mild to moderately depressed patients (77 percent) but only two of nine severely depressed patients (22 percent) responded (p<0.03). The two groups of patients had statistically similar HDRS decreases, the investigators add.
Bipolar Disorders, 2002; 4: 296-301. "Gabapentin augmentation therapy in bipolar depression."

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