Gabapentin in Alcohol Dependence

Objective: To review the literature related to the use of gabapentin in alcohol dependence following acute alcohol withdrawal. Data Sources: Searches of MEDLINE (1946-January 2015) and Cochrane Database (2005-January 2015) were performed using gabapentin, alcohol, and alcoholism as MeSH terms and keywords. Results were limited to human trials in English-language journals. Study Selection and Data Extraction: Inclusion criteria included randomized controlled trials with a minimum 4 weeks of gabapentin therapy and at least one alcohol dependence related outcome measure (ie, cravings, abstinence, percent days abstinent, or heavy drinking days). Six randomized clinical trials were identified. Data Synthesis: Four trials identified beneficial effects of gabapentin on at least one alcohol-related outcome measure. Two smaller studies, which enrolled patients with minimal withdrawal symptoms, failed to demonstrate beneficial effects on primary outcomes related to heavy drinking or abstinence. Gabapentin at doses up to 1800 mg daily was well tolerated with no serious adverse drug reactions being reported. Conclusions: Clinical trials have shown gabapentin is a well-tolerated adjunctive therapy in the management of alcohol dependence. The strongest efficacy evidence occurred in patients experiencing moderate to severe withdrawal when gabapentin was administered early in or concurrently during acute withdrawal and continued for up to 12 weeks.