F. Garonna, T. Meneghin, L. Stifani - Volume 5, Settembre 1999, n. 3
Testo Immagini Bibliografia Summary Riassunto Indice
Il trattamento dell’episodio
maniacale con gabapentin in monoterapia: un’esperienza clinica
The treatment of manic episode with gabapentin
monotherapy: a clinical trial
Background: manic episodes are the crucial clinical event in the course of bipolar disorders and their treatment aims at stabilising them to allow for control of mood in this group of disorders. Recently, based on a kindling hypothesis of bipolar disorders, anticonvulsive agents were administered in bipolar disorders and proved to be effective, either alone or as lithium augmentation. Gabapentin is an antikindling agent acting on glutamatergic and GABAergic transmissions, thereby modulating also monoaminergic transmitters involved in manic episodes.
Methods: eleven in-patients (3 females and 8 males) with DSM-IV bipolar disorder with (N=4) or without (N=7) psychotic features were given oral gabapentin alone, at a mean starting dose of 1100 mg/die (range 900-1600 mg/die), to treat their acute manic episode. The drug was rapidly titrated to a mean dosage of 2500 mg/die (range 1500-3300 mg/die) within seven days.
Results: a satisfactory clinical response was obtained in 82% of patients. Gabapentin reduced excitement, behavioural and cognitive disorganisation, aggressiveness and hostility, and insomnia. Compliance was easy to obtain and was gained earlier. No effect was seen on psychotic reasoning and thinking. No serious side effects emerged during treatment.
Conclusion: gabapentin improved the clinical status of patients with bipolar disorder during their manic episode, thereby rendering them more manageable through other means. Furthermore, it reduced the need for hospital stay.