Gabapentin is an anti-seizure medication. It is sold in the United States under the trade name Neurontin.
Gabapentin is used in combination with other antiseizure (anticonvulsant) drugs to manage partial seizures with or without generalization in individuals over the age of 12. Gabapentin can also be used to treat partial seizures in children between the ages of three and 12. Off-label uses (legal uses not specifically approved by the United States Food and Drug Administration [FDA]) include treatment of severe, chronic pain caused by nerve damage (such as occurs in shingles, diabetic neuropathy, multiple sclerosis, or post-herpetic neuralgia). Studies are also looking at using gabapentin to treat bipolar disorder (also known as manic-depressive disorder).
Brain cells normally transmit nerve impulses from one cell to another by secreting chemicals known as neurotransmitters.
Gabapentin is chemically related to a naturally occurring neurotransmitter called GABA (gamma-amino butyric acid). The actual mechanism of action by which gabapentin acts in the brain to control seizures and treat pain is not known, although it appears to alter the action of nerve cells.
Gabapentin was approved for use in the United States in 1993. A liquid formulation was approved for use in 2000. Use in children ages three to 12 was also approved by the FDA in 2000.
Gabapentin is available in 100-, 300-, and 400-mg capsules; in 600- and 800- mg tablets; and in a liquid solution containing 250 mg per 5 ml.
People over the age of 12 should be started on 300 mg gabapentin taken three times a day. The dose can be increased up to a total of 1,800 mg per day. In some instances, doses of up to 3,600 mg per day have been tolerated.
Children should receive a dosage of 10-15 mg per kg of body weight per day, divided into three equal doses.
Chronic pain may be treated with 300-3,600 mg per day, divided into three equal doses.
When gabapentin is used for bipolar disorder, the starting dose is usually 300 mg taken at bedtime. Depending on the patient's response, the dose can be increased every four to seven days. Many people receive maximum therapeutic benefit at 600 mg per day, although some people have required up to 4,800 mg per day.
Women who are breast-feeding and people who have decreased kidney functioning should discuss the risks and benefits of this drug with their physician. Women who are or wish to become pregnant will also require a careful assessment of the risks and benefits of gabapentin.
Patients should not suddenly discontinue gabapentin, as this can result in an increased risk of seizures. If the medication needs to be discontinued, the dosage should be reduced gradually over a week.
Until an individual understands the effects that gabapentin may have, he or she should avoid driving, operating dangerous machinery, or participating in hazardous activities. Alcohol should be avoided while taking gabapentin.
Patients who experience the following side effects of gabapentin should check with their doctor immediately.
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