Gabapentin in the treatment of adolescent mania: a case report

Gabapentin is a new antiepileptic drug with an unknown mechanism of action and very favorable pharmacokinetic and safety profiles. An increasing number of reports have described the successful use of gabapentin in bipolar disorder in adults. A 13-year-old boy with bipolar I disorder, manic episode, and ADHD, was treated with gabapentin 1,500 mg/day as add-on therapy to carbamazepine and showed a marked response within 1 month. He had previously failed a divalproex trial, could not tolerate lithium, and carbamazepine could not control his symptoms and induced a low WBC. He remained euthymic 7 months after gabapentin was added. His Young Mania Rating Scale (YMRS) score was 27 when gabapentin was added, 9 after 1 month, 15 after 4 months, and 6 after 7 months. Controlled studies are needed to evaluate the possible anti-manic, mood stabilizing, and/or anti-depressant properties of gabapentin in youth.