Can You Take Gabapentin for Bipolar Disorder?

Gabapentin (Neurontin) is one of the top ten most frequently prescribed medications in the U.S. It’s an anti-epileptic medication that can treat seizures. But it can also treat many other conditions — both on and off-label. And, spoiler alert, the benefits don’t always live up to the hype. The popularity of gabapentin is the result of decades-long, misleading marketing campaigns. 

Gabapentin does work well for some conditions. There’s good evidence that gabapentin is helpful for certain types of nerve pain and anxiety. 

But what about bipolar disorder? Not so much. The truth is, according to research studies, gabapentin is not an effective treatment for bipolar disorder. 

Read on for more information about how gabapentin was marketed for treating bipolar disorder in the past and what the current research says about gabapentin and bipolar disorder. 

What does research say about gabapentin treatment for bipolar disorder?

There’s no evidence that gabapentin works for treating bipolar disorder. This is a misconception fueled by an unethical drug company marketing campaign from the 1990s. The manufacturer of brand-name gabapentin (Neurontin) heavily marketed it for many different off-label uses, including bipolar disorder. At the time, the manufacturer had no good scientific evidence to support these claims — only industry-funded, poor-quality studies. 

In 1996, a whistleblower from inside the drug company came forward. He claimed that company employees were trained to aggressively market Neurontin to doctors for off-label uses. Employees were also encouraged to “exaggerate the results of studies that were too small to prove anything, and to hide reports of side effects or trials that showed Neurontin did not work for various conditions.” 

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This led to a $430 million false claims settlement in 2004, after it was determined that the drug company had inappropriately promoted off-label uses of gabapentin and defrauded the federal government. 

Since that time, researchers have continued to investigate gabapentin. But according to literature reviews from 2015, 2021, and again in 2021, there’s no significant evidence that gabapentin is effective for treating bipolar disorder — either on its own or as an add-on medication. In fact, in some studies, gabapentin actually performed worse than placebo. 

Here’s what the experts say about gabapentin and bipolar disorder:

• American Psychological Association: Gabapentin has been “largely discredited as a mood stabilizer for bipolar disorder.”

• Depression and Bipolar Support Alliance: Gabapentin “was used frequently for treatment of bipolar disorder, but controlled studies found it was no more effective than a placebo.”

• American Academy of Child and Adolescent Psychiatry: Gabapentin has “not been shown to effectively treat mania or depression associated with bipolar disorder.”

In short, there are much better medications for bipolar disorder than gabapentin — especially since there’s growing evidence that gabapentin has significant risks. 

Can gabapentin cause mania?

Just like all medications, gabapentin can cause some side effects. For most people, these side effects are mild, and they include:

• Fatigue

• Dizziness

• Tremor 

• Upset stomach

• Constipation or diarrhea

• Arm and leg swelling

When taken as directed, mania is not a typical side effect of gabapentin. But keep in mind: People who misuse gabapentin say it can feel stimulating, like cocaine. They report feeling more talkative, having increased energy, and feeling euphoric — symptoms that are similar to mania. You should not take gabapentin unless a healthcare provider specifically recommends it.

What else is gabapentin used for? 

The FDA has approved gabapentin (Neurontin) for:

• Seizures

• Nerve pain from shingles (postherpetic neuralgia, or PHN)

Another version of gabapentin (Horizant) is approved to treat restless leg syndrome and PHN. 

There’s also Gralise, an extended-release version of gabapentin, which is only approved for PHN.

Healthcare providers also frequently prescribe it off-label for dozens of conditions — including bipolar disorder, chronic back pain, and anxiety. Most of these indications (like bipolar disorder and chronic back pain) do not have good evidence supporting them. But for some of these off-label uses, it can be helpful. For example, there’s some evidence that gabapentin is helpful for certain types of anxiety and for treating substance use disorders. 

So, is gabapentin good for bipolar disorder?

As we’ve seen, bipolar disorder is an off-label use for gabapentin. And after decades of research, experts do not recommend gabapentin as a treatment for bipolar disorder. 

The treatment for bipolar disorder uses a combination of medications, including mood stabilizers, other anticonvulsants, and antipsychotics. Examples include lithium, seroquel, lamictal, and more. 

If you have bipolar disorder and you also have anxiety or a substance use disorder, your healthcare provider might suggest adding on gabapentin.

Why trust our experts?

Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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