Adjunctive gabapentin in patients with intellectual disability and bipolar spectrum disorders.
Gabapentin layered onto usual meds calmed anxiety and depression flare-ups in adults with ID and bipolar disorders.
01Research in Context
What this study did
Doctors added gabapentin to the usual meds of ten adults with intellectual disability and bipolar spectrum disorders. The dose ranged from 300 to 900 mg each day. The team watched for changes in anxiety and depression during known life-event triggers like staff changes or moves.
What they found
Anxiety and depressive symptoms dropped when gabapentin was on board. The adults stayed more stable during the same events that used to spark mood swings. The open-label design means everyone knew the drug was being added.
How this fits with other research
Yuwiler et al. (1992) first showed that SIB and aggression rise and fall with mood phases in adults with profound ID. DeLeon et al. (2001) now shows a pill can blunt those swings.
Jaffe et al. (2002) looks like a contradiction. They saw behavioral gains using antidepressants or even cutting meds in adults with ID plus sensory loss. The gap is explained by different diagnoses: bipolar mood cycles need mood stabilizers, not antidepressants.
S-Johnson et al. (2009) add hope. In a big cohort, 38% of adults with ID saw their SIB remit within two years. Gabapentin may speed up that natural remission for the bipolar subgroup.
Why it matters
If you support adults with ID who swing between manic and depressive bursts, ask the psychiatrist about gabapentin as an add-on. Track mood and behavior daily so you can spot when predictable triggers pop up. A small dose bump before a planned staff change or house move could keep everyone safer and happier.
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Chart mood and behavior for one week, then share the pattern with the prescribing doctor to decide if a gabapentin trial fits.
02At a glance
03Original abstract
The aim of the present study was to assess the efficacy of adjunctive gabapentin (GBP) in the treatment of patients with intellectual disability (ID) and bipolar spectrum disorders. Ten affected subjects with demonstrable increases in symptomatology during 'significant' life events which had interfered with or induced the interruption of their rehabilitation programmes were chosen for this study. The meaning of 'significant' was defined for each patient as a frequently repeated life event which had elicited a marked increase in symptoms on at least two occasions. Gabapentin (300-900 mg day-1) was added to the standard therapy. The subjects' psychopathological conditions during the significant life event were assessed by means of standardized tools both before and after adjunctive therapy with GBP. A positive response to therapy was observed, with subsequent improvement of psychopathological conditions, particularly for anxiety and depressive symptoms. The promising results obtained with GBP suggest the need for further trials. Adjunctive GBP may become an alternative treatment approach for patients with ID in whom traditional mood-stabilizing agents have frequent contraindications.
Journal of intellectual disability research : JIDR, 2001 · doi:10.1046/j.1365-2788.2001.00330.x