Gabapentin and lamotrigine: Prescribing guidelines for psychiatry

Certain anticonvulsants, in particular valproate and carbamazepine, that were initially used to treat epilepsy have subsequently been found to be effective in the treatment of psychiatric disorders, especially bipolar disorder. Gabapentin and lamotrigine are two new anticonvulsants that appear to have mood stabilizing properties. The authors review the pharmacology, pharmacokinetics, and adverse effects of these two agents and review the promising preliminary findings concerning their efficacy as mood stabilizers. The authors suggest that, until well-controlled studies of gabapentin and lamotrigine are completed establishing efficacy, tolerability, and optimal dosing, these agents should be reserved for the treatment of patients who do not respond to or cannot tolerate the standard treatments. Placebo-controlled, randomized, multicenter trials of both drugs in psychiatric disorders are currently underway that should provide further information on the use of these agents for psychiatric disorders. Copyright