A Randomized, Open‐Label, Controlled Trial of Gabapentin and Phenobarbital in the Treatment of Alcohol Withdrawal

Mariani, John J.; Rosenthal, Richard N.; Tross, Susan; Singh, Prameet; Anand, Om

doi:10.1080/10550490500419110

Cited by 85 publications

(72 citation statements)

References 33 publications

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“…Gabapentin is an analog of GABA with anticonvulsant properties, and it has been used to treat ethanol withdrawal in humans (Book and Myrick, 2005;Mariani et al, 2006;Bonnet et al, 2007;Myrick et al, 2007). However, little is known of its mechanism of action.…”

Section: Discussionmentioning

confidence: 99%

“…Gabapentin has been used effectively in the treatment of alcohol withdrawal in alcoholics (Bonnet et al, 1999(Bonnet et al, , 2007Bozikas et al, 2002;Gentry et al, 2002;Voris et al, 2003;Book and Myrick, 2005;Mariani et al, 2006;Myrick et al, 2007) and has a selective action in decreasing the convulsive and anxiety-related signs of ethanol withdrawal in mice (Watson et al, 1997). Gabapentin decreases ethanol-induced anxiety-like behavior in the elevated plus maze, but has no effect on motor coordination or spontaneous locomotor activity in control mice (Watson et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

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Cellular and Behavioral Interactions of Gabapentin with Alcohol Dependence

Roberto¹,

Gilpin²,

O’Dell³

et al. 2008

J. Neurosci.

117

128

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Gabapentin is a structural analog of GABA that has anticonvulsant properties. Despite the therapeutic efficacy of gabapentin, its molecular and cellular mechanisms of action are unclear. The GABAergic system in the central nucleus of the amygdala (CeA) plays an important role in regulating voluntary ethanol intake. Here, we investigated the effect of gabapentin on GABAergic transmission in CeA slices, on ethanol intake, and on an anxiety measure using animal models of ethanol dependence. Gabapentin increased the amplitudes of evoked GABA receptor-mediated IPSCs (GABA-IPSCs) in CeA neurons from nondependent rats, but decreased their amplitudes in CeA of ethanol-dependent rats. Gabapentin effects were blocked in the presence of a specific GABA B receptor antagonist. The sensitivity of the GABA-IPSCs to a GABA B receptor antagonist and an agonist was decreased after chronic ethanol, suggesting that ethanol-induced neuroadaptations of GABA B receptors associated with ethanol dependence may account for the differential effects of gabapentin after chronic ethanol. Systemic gabapentin reduced ethanol intake in dependent, but not in nondependent, rats and reversed the anxiogeniclike effects of ethanol abstinence using an acute dependence model. Gabapentin infused directly into the CeA also blocked dependenceinduced elevation in operant ethanol responding. Collectively, these findings show that gabapentin reverses behavioral measures of ethanol dependence and, in turn, dependence reverses the effects of gabapentin on CeA neurons, and suggest that gabapentin represents a potential medication for treatment of alcoholism.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cellular and Behavioral Interactions of Gabapentin with Alcohol Dependence

Roberto¹,

Gilpin²,

O’Dell³

et al. 2008

J. Neurosci.

117

128

View full text Add to dashboard Cite

show abstract

“…Gabapentin, however, has not been shown to prevent alcohol withdrawal seizures. 43 An open-label study of 20 institutionalized patients with probable Alzheimer's disease who received gabapentin found reductions in behavioral and psychotic symptoms. 44 In summary, there is little evidence for gabapentin to support previous anecdotal impressions about potential benefits in bipolar disorder.…”

Section: Gabapentinmentioning

confidence: 99%

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

2007

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Summary: Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.

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“…In humans, it is used for the treatment of alcohol withdrawal in alcoholics (Bonnet et al 1999(Bonnet et al , 2007Bozikas et al 2002;Gentry et al 2002;Voris et al 2003;Book and Myrick 2005;Mariani et al 2006;Myrick et al 2007). Gabapentin ability to reduce craving in non-treatment-seeking alcohol abusers was also demonstrated (Mason et al 2009).…”

Section: Introductionmentioning

confidence: 96%