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Gabapentin does not alter single-dose lithium pharmacokinetics

M A Frye1, T A Kimbrell, R T Dunn

  • 1Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland 20892, USA. maf@helix.nih.gov

Journal of Clinical Psychopharmacology
|December 24, 1998
PubMed
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This study found that high-dose gabapentin does not significantly alter lithium pharmacokinetics in patients with normal kidney function. This suggests that combining lithium and gabapentin may be safe for managing bipolar disorder.

Area of Science:

  • Pharmacology
  • Nephrology
  • Psychiatry

Background:

  • Lithium (Li) and gabapentin are renally excreted.
  • Potential for drug-drug interactions affecting lithium levels due to narrow therapeutic index.
  • Need to assess safety of co-administration.

Purpose of the Study:

  • To examine the pharmacokinetic profiles of lithium when co-administered with steady-state gabapentin.
  • To determine if gabapentin alters lithium renal excretion and short-term pharmacokinetics.
  • To evaluate the clinical implications for managing bipolar disorder.

Main Methods:

  • Single-dose pharmacokinetic study in 13 patients.
  • Patients received placebo and then steady-state gabapentin (mean 3,646.15 mg/day).
  • Single 600-mg oral lithium dose administered in both phases; serial lithium levels measured over 72 hours.

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Main Results:

  • No significant difference in lithium area under the concentration-time curve (AUC) between gabapentin and placebo phases.
  • No significant difference in maximal lithium concentration (Cmax) or time to reach peak concentration (Tmax).
  • High-dose gabapentin did not alter short-term lithium pharmacokinetics in patients with normal renal function.

Conclusions:

  • Gabapentin, at high therapeutic doses, does not appear to cause clinically significant alterations in short-term lithium pharmacokinetics.
  • Preliminary data suggest co-administration of lithium and gabapentin may be feasible for bipolar disorder management.
  • Further controlled studies with larger, diverse populations and longer assessment durations are warranted.