Gabapentin for the treatment of acute mania

We present the case of a 60-year old bipolar-l-patient showing a rapid anti manic response to gabapentin after having been non-responsive to lithium an d perazine. This case encouraged us to further evaluate the antimanic poten cy of gabapentin in an open label trial. 20 patients with acute mania were treated for up to 21 days with gabapentin in a dose range from 1200 to 4800 mg/day. Ten patients were treated with gabapentin as add-on medication and ten patients were treated with a high dose of gabapentin alone. The BRMAS score declined significantly in patients with moderate mania, whereas gabap entin alone was not efficacious in patients with very severe mania. Keeping in mind the limitations of an open study, it can still be said that gabape ntin as add-on medication with other effective mood stabilizers appears to be safe and efficacious in the treatment of moderate mania.