title: Gabapentin Therapy in Psychiatric Disorders: A Systematic Review.
abstract: OBJECTIVE
  Gabapentin is commonly used off-label in the treatment of psychiatric disorders with success, failure, and controversy. A systematic review of the literature was performed to elucidate the evidence for clinical benefit of gabapentin in psychiatric disorders.
  
  
  METHODS
  Bibliographic reference searches for gabapentin use in psychiatric disorders were performed in PubMed and Ovid MEDLINE search engines with no language restrictions from January 1, 1983, to October 1, 2014, excluding nonhuman studies. For psychiatric references, the keywords bipolar, depression, anxiety, mood, posttraumatic stress disorder (posttraumatic stress disorder and PTSD), obsessive-compulsive disorder (obsessive-compulsive disorder and OCD), alcohol (abuse, dependence, withdraw), drug (abuse, dependence, withdraw), opioid (abuse, dependence, withdraw), cocaine (abuse, dependence, withdraw), and amphetamine (abuse, dependence, withdraw) were crossed with gabapentin OR neurontin.
  
  
  METHODS
  The resulting 988 abstracts were read by 2 reviewers; references were excluded if gabapentin was not a study compound or psychiatric symptoms were not studied. The resulting references were subsequently read, reviewed, and analyzed; 219 pertinent to gabapentin use in psychiatric disorders were retained. Only 34 clinical trials investigating psychiatric disorders contained quality of evidence level II-2 or higher.
  
  
  RESULTS
  Gabapentin may have benefit for some anxiety disorders, although there are no studies for generalized anxiety disorder. Gabapentin has less likely benefit adjunctively for bipolar disorder. Gabapentin has clearer efficacy for alcohol craving and withdrawal symptoms and may have a role in adjunctive treatment of opioid dependence. There is no clear evidence for gabapentin therapy in depression, PTSD prevention, OCD, or other types of substance abuse. Limitations of available data include variation in dosing between studies, gabapentin as monotherapy or adjunctive treatment, and differing primary outcomes between trials.
  
  
  CONCLUSIONS
  Further research is required to better clarify the benefit of gabapentin in psychiatric disorders.
authors.affiliation: Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts.
authors.forename: Rachel K
authors.initials: RK
authors.lastname: Berlin
authors.affiliation: Department of Neurology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Butler
authors.affiliation: Department of Neurology, Boston University School of Medicine, Boston University Medical Center, Boston, Massachusetts.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Perloff
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