pregabalin and Bipolar-Disorder

The gabapentinoids, gabapentin, and pregabalin, target the α

Topics: Amines; Anxiety; Bipolar Disorder; Calcium Channels; Cyclohexanecarboxylic Acids; Gabapentin; gamma-Aminobutyric Acid; Humans; Pregabalin; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders

Topics: Bipolar Disorder; Gabapentin; Humans; Pregabalin; Sleep Initiation and Maintenance Disorders

Gabapentin has been extensively prescribed off-label for psychiatric indications, with little established evidence of efficacy. Gabapentin and pregabalin, a very similar drug with the same mechanism of action, bind to a subunit of voltage-dependent calcium channels which are implicated in the aetiopathogenesis of bipolar disorder, anxiety and insomnia. This systematic review and meta-analysis aims to collect and critically appraise all the available evidence about the efficacy and tolerability of gabapentin and pregabalin in the treatment of bipolar disorder, insomnia and anxiety.. We will include all randomised controlled trials (RCTs) reported as double-blind and comparing gabapentin or pregabalin with placebo or any other active pharmacological treatment (any preparation, dose, frequency, route of delivery or setting) in patients with bipolar disorder, anxiety or insomnia. For consideration of adverse effects (tolerability), single-blind or open-label RCTs and non-randomised evidence will also be summarised. The main outcomes will be efficacy (measured as dichotomous and continuous outcome) and acceptability (proportion of patients who dropped out of the allocated treatment). Published and unpublished studies will be sought through relevant database searches, trial registries and websites; all reference selection and data extraction will be conducted by at least 2 independent reviewers. We will conduct a random-effects meta-analysis to synthesise all evidence for each outcome. Heterogeneity between studies will be investigated by the I. This review does not require ethical approval. This protocol has been registered on PROSPERO (CRD42016041802). The results of the systematic review will be disseminated via publication in a peer-reviewed journal.

Topics: Amines; Anti-Anxiety Agents; Anxiety Disorders; Bipolar Disorder; Cyclohexanecarboxylic Acids; Double-Blind Method; Gabapentin; gamma-Aminobutyric Acid; Humans; Pregabalin; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders; Systematic Reviews as Topic; Treatment Outcome

Pediatric epilepsy is a common, chronic, and challenging physical illness for children and their families. This article provides a medical overview and discusses the cognitive functioning and psychosocial adjustment as well as the psychiatric management for children and adolescents with pediatric epilepsy. The management of these children involves establishing a collaborative health care approach, evaluating academic functioning, considering psychotherapy, and managing psychopharmacologic treatment. A thorough understanding of the biopsychosocial concerns in pediatric epilepsy can enable medical providers and mental health clinicians to promote resiliency and adaptation in children and their families facing troubling seizure disorders.

Topics: Adolescent; Amines; Anxiety Disorders; Bipolar Disorder; Child; Child, Preschool; Cyclohexanecarboxylic Acids; Cyclohexanols; Epilepsy; Gabapentin; gamma-Aminobutyric Acid; Humans; Mental Disorders; Norepinephrine; Pregabalin; Selective Serotonin Reuptake Inhibitors; Valproic Acid; Venlafaxine Hydrochloride; Young Adult

The anticonvulsants valproate and carbamazepine have efficacy in treating acute mania, but their efficacy in treating acute bipolar depression and preventing mood episodes remains uncertain. Despite this, and given their utility and widespread use, both are widely accepted as standard treatments for bipolar disorder. All the newer anticonvulsants that have become available during the last decade have been or are being assessed to determine their efficacy in the treatment of various phases of bipolar disorder. Among the newer anticonvulsants, some appear to have efficacy in treating core bipolar symptoms, while others have efficacy in treating psychiatric comorbidity such as substance abuse or an anxiety disorder. Lamotrigine is the most widely studied and is effective in treating and preventing bipolar depression, and it is the only anticonvulsant approved by the U.S. Food and Drug Administration as a maintenance treatment for bipolar disorder. Other newer anticonvulsants, levetiracetam, oxcarbazepine, phenytoin, and zonisamide offer promise, but further studies are required before they can be recommended for routine use to treat bipolar disorder. Gabapentin and topiramate do not appear to have efficacy in treating acute mania, but their utility in bipolar depression and prevention of mood episodes has not been studied in double-blind trials. Pregabalin has utility in treating generalized anxiety disorder, but it has not been studied in bipolar disorder. Given the success of lamotrigine in treating bipolar disorder, further double-blind controlled trials of the newer anticonvulsants in treating bipolar disorder are warranted. This article summarizes current evidence from trials of anticonvulsants in bipolar disorder and makes recommendations for their clinical use.

Topics: Acetates; Amines; Anticonvulsants; Bipolar Disorder; Carbamazepine; Cyclohexanecarboxylic Acids; Depressive Disorder; Fructose; Gabapentin; gamma-Aminobutyric Acid; Humans; Isoxazoles; Lamotrigine; Levetiracetam; Nipecotic Acids; Oxcarbazepine; Phenytoin; Piracetam; Pregabalin; Tiagabine; Topiramate; Treatment Outcome; Triazines; Zonisamide

Topics: Affect; Bipolar Disorder; Humans; Pregabalin

Pregabalin is a gamma-aminobutyric acid (GABA) analogue approved for the treatment of neuropathic pain, partial seizure and generalized anxiety disorder. As a GABA analogue, there is a raising concern regarding the abuse potential of this drug.. We present a first case of pregabalin dependence in a 26-year-old woman without a previous history of illicit drug abuse.. Physician should be aware about the addictive potential of pregabalin even in patients without a previous history of substance abuse.

Topics: Adult; Analgesics; Anxiety; Bipolar Disorder; Craving; Depressive Disorder, Major; Female; Humans; Pregabalin; Substance-Related Disorders

Topics: Anticonvulsants; Bipolar Disorder; Conversion Disorder; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Pregabalin

Topics: Adult; Akathisia, Drug-Induced; Anticonvulsants; Antipsychotic Agents; Aripiprazole; Bipolar Disorder; Female; gamma-Aminobutyric Acid; Humans; Piperazines; Pregabalin; Quinolones

Pregabalin is a structural analog of GABA, similar to gabapentin. It does not have a FDA indication for any psychiatric disorder in the USA. There has been one case report of the successful use of pregabalin as an augmenting agent in a patient with Bipolar Disorder (BD). In the present open label study, not subsidized by the manufacturer, the investigators prospectively evaluated the acute and maintenance efficacy of pregabalin as an adjunctive medication for a group of treatment refractory outpatients with BD.. Older adolescent and adult outpatients with any type of DSM-IV diagnosed BD, who were considered treatment nonresponders to multiple standard medications for BD, were treated with adjunctive pregabalin. The baseline mood state before initiation of pregabalin was compared to the mood state after an acute trial of pregabalin using the Clinical Global Impression-Bipolar Version Scale (CGI-BP). All acute responders were treated for a minimum of two months. Follow-up maintenance treatment data was obtained for the acute pregabalin responders for three years after the 18 month acute phase of the study.. Fifty-eight total patients were treated adjunctively with pregabalin. Twenty-four (41%) were rated as acute responders. For the acute responders, pregabalin produced either a mood stabilizing effect, antidepressant effect or antimanic effect. Intolerable side-effects were the most common reason (79%) for a failed acute trial of pregabalin. None of the side effects resulted in serious medical complications. No patient abused pregabalin, and there were no adverse drug-drug interactions despite an average of 3.3 concurrent other psychiatric medications. The maintenance data revealed that 10 (42%) of the original 24 acute pregabalin responders were still taking pregabalin as an add-on medicine for an average of 45.2 months (range 42-48, SD: 2.35).. This study has an open label observation design.. The results of this preliminary open study suggest that pregabalin is a safe and effective acute and maintenance adjunctive treatment for a significant number of treatment-resistant outpatients with any type of BPD. It appears to have mood stabilizing and antidepressant properties in addition to antimanic effects. Similar studies using a double-blind, randomly controlled design would be useful to confirm the reliability and validity of the results of this study.

Topics: Adolescent; Adult; Affect; Aged; Aged, 80 and over; Antimanic Agents; Bipolar Disorder; Female; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Outpatients; Pregabalin; Young Adult

Topics: Bipolar Disorder; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Pregabalin; Substance-Related Disorders; Treatment Outcome