Facts About Neurontin and Its Off-Label Use in Bipolar Disorder

Side Effects and Controversy of This Anti-Seizure Medication

Woman clutching her head in mental anguish. Credit: Peter Dazeley / Getty Images

Neurontin (gabapentin) is sometimes prescribed off-label to treat bipolar disorder.

Let's review the basics on Neurontin, including side effects and whether science supports its use as a mood stabilizer.

What Medical Conditions is Neurontin Approved to Treat?

Neurontin is a medication approved by the FDA to treat partial seizures and postherpetic neuralgia, pain that remains after someone has shingles.


What are the Potential Serious Side Effects of Neurontin?

According to the FDA, Neurontin may increase the risk of suicidal thoughts or behavior. Patients treated with any anti-seizure medications, like Neurontin, should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.

Neurontin may also cause a serious allergic reaction or affect a person's liver or blood cells.

Signs of an allergic reaction may include a rash, trouble breathing, fever, swollen glands that don't get better, or swelling of the face, lips, throat, or tongue. 

Symptoms or signs of liver or blood cell problems may include:

  • yellowing of the skin or eyes
  • out of the ordinary bruising or bleeding
  • severe fatigue
  • out of the ordinary muscle pain
  • frequent infections

Neurontin can also make a person feel dizzy or sleepy. This can affect their driving abilities.

According to the FDA and manufacturer, it's important to discuss with your doctor whether it's safe for you to drive while on Neurontin.

It's also advised to avoid alcohol and not take other medications with Neurontin until you speak with your doctor, as this can worsen your sleepiness. 

What are the Potential Common Side Effects of Neurontin?

These include:

  • loss of balance or coordination
  • fatigue and/or drowsiness
  • infection with viruses
  • fever
  • jerky movements
  • nausea and vomiting
  • difficulty speaking
  • double vision
  • tremor
  • unusual eye movements

What is the Controversy Surrounding Neurontin's Use in Treating Bipolar Disorder?

While a number of anti-seizure medications, like Tegretol (carbamazepine), valproate, and Lamictal (lamotrigine), are approved by the FDA for treating bipolar disorder, Neurontin (gabapentin) is not. 

In 1993, Neurontin was approved by the FDA for the treatment of partial complex seizures, in combination with another anti-seizure medication. It was then marketed by its manufacturer for off-label use in treating bipolar disorder, despite the fact that there was not sufficient scientific data to back it up. A lawsuit resulted, as it was believed that Neurontin was marketed fraudulently for unapproved uses. 

Does Science Support Neurontin's Use for Bipolar Disorder?

A 2009 review in General Hospital Psychiatry, regarding gabapentin as a mood stabilizer, found no reports of studies meeting high-quality criteria — and the results of those studies examined were mixed, favoring a negative role for gabapentin's use in treating bipolar disorder.


That being said, according to a 2007 review study in the Annals of General Psychiatry, Neurontin can be used as supplementary therapy for the treatment of anxiety in patients with bipolar disorder. 

What Should I Do?

It's always a good idea to be knowledgeable about your medications. That being said, do not stop taking a medication without first speaking with your doctor. While the science is not robust regarding gabapentin's effectiveness in treating bipolar disorder, it may just work for you —  each person has to evaluate his or her response with their doctor.


FDA. (Revised 2015). Medication Guide: Neurontin. Retrieved November 11th 2015. 

Fountoulakis KN et al. Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder. Ann Gen Psychiatry. 2007 Oct 9;6:27. 

Melvin CL et al. Effectiveness of antiepileptic drugs for the treatment of bipolar disorder: findings from a systematic review. J Psychiatr Pract. 2008 Mar;14 Suppl 1:9-14.

Pande AC, Crockatt JG, Janney CA, Werth JL & Tsaroucha G. Gabapentin in bipolar disorder: a placebo-controlled trial of adjunctive therapy. Gabapentin Bipolar Disorder Study Group. Bipolar Disord. 2000 Sep;2(3 Pt 2):249-55.

Williams JW Jr, Ranney L, Morgan LC & Whitener L. How reviews covered the unfolding scientific story of gabapentin for bipolar disorder. Gen Hosp Psychiatry 2009 May-Jun;31(3):279-87.

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