The Efficacy of Gabapentin in the Treatment of Alcohol Use Disorder
A Comprehensive Review
DOI:
https://doi.org/10.12775/QS.2024.19.53902Keywords
alcohol withdrawal syndrome, gabapentin, Alcohol Use DisorderAbstract
Introduction:
Alcohol Use Disorder (AUD) is a significant medical condition characterized by an inability to control alcohol use despite adverse consequences, ranging from occasional excessive drinking to daily dependency. Treatment for AUD involves a combination of pharmacological and behavioral approaches. Common medications include Disulfiram, Naltrexone, and Acamprosate, with newer therapies like gabapentin providing additional options. This review aims to systematically evaluate and synthesize available research concerning the use of gabapentin in the treatment of AUD.
Methods:
This review was created based on 4 articles found in PubMed and Pubmed database based on keywords: "alcohol use disorder", "gabapentine in alcohol use disorder" and "gabapentine".
State of knowledge:
Gabapentin was originally developed for its anticonvulsant properties and tts primary use was to treat epilepsy by reducing the frequency of seizures in patients with refractory epilepsy. Gabapentin’s effectiveness in treating Alcohol Use Disorder is founded on its ability to modulate neuronal excitability. Recent RCTs have demonstrated the efficacy of gabapentin in alcohol use disorder, especially for patients with a history of significant alcohol withdrawal symptoms, though the extended-release formulation of gabapentin proved ineffective.
Conculsions:
The overall findings suggest gabapentin holds promise as a treatment for AUD, particularly in individuals with significant withdrawal symptoms, but additional studies are required to fully establish its efficacy and optimal use.
References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5. 5th edition. American Psychiatric Publishing; 2013.
GBD 2016 Alcohol and Drug Use Collaborators. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 [published correction appears in Lancet Psychiatry. 2019 Jan;6(1):e2]. Lancet Psychiatry. 2018;5(12):987-1012. doi:10.1016/S2215-0366(18)30337-7
Rehm, J., Anderson, P., Barry, J., Dimitrov, P., Elekes, Z., Feijão, F., Frick, U., Gual, A., Jr., G., Kraus, L., Marmet, S., Raninen, J., Rehm, M., Scafato, E., Shield, K., Trapencieris, M., & Gmel, G. (2014). Prevalence of and Potential Influencing Factors for Alcohol Dependence in Europe. European Addiction Research, 21, 6 - 18. https://doi.org/10.1159/000365284.
Keyes, K., Grant, B., & Hasin, D. (2008). Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population.. Drug and alcohol dependence, 93 1-2, 21-9 . https://doi.org/10.1016/J.DRUGALCDEP.2007.08.017.
Santana NMT, Mill JG, Velasquez-Melendez G, et al. Consumption of alcohol and blood pressure: Results of the ELSA-Brasil study. PLoS One. 2018;13(1):e0190239. Published 2018 Jan 8. doi:10.1371/journal.pone.0190239
GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 [published correction appears in Lancet. 2018 Sep 29;392(10153):1116] [published correction appears in Lancet. 2019 Jun 22;393(10190):e44]. Lancet. 2018;392(10152):1015-1035. doi:10.1016/S0140-6736(18)31310-2
Sullivan EV, Harris RA, Pfefferbaum A. Alcohol's effects on brain and behavior. Alcohol Res Health. 2010;33(1-2):127-143.
Rehm J, Shield KD, Weiderpass E. Alcohol consumption. A leading risk factor for cancer. Chem Biol Interact. 2020;331:109280. doi:10.1016/j.cbi.2020.109280
Room, R., Babor, T., & Rehm, J. (2005). Alcohol and public health. The Lancet, 365, 519-530. https://doi.org/10.1016/S0140-6736(05)17870-2.
Castrén S, Mäkelä N, Alho H. Selecting an appropriate alcohol pharmacotherapy: review of recent findings. Curr Opin Psychiatry. 2019;32(4):266-274. doi:10.1097/YCO.0000000000000512
De Sousa, A. (2019). Disulfiram: Pharmacology and Mechanism of Action. In: Disulfiram. Springer, Singapore. https://doi.org/10.1007/978-981-32-9876-7_2
Ray LA, Green R, Roche DJO, Magill M, Bujarski S. Naltrexone effects on subjective responses to alcohol in the human laboratory: A systematic review and meta-analysis. Addict Biol. 2019;24(6):1138-1152. doi:10.1111/adb.12747
Littleton JM. Acamprosate in alcohol dependence: implications of a unique mechanism of action. J Addict Med. 2007;1(3):115-125. doi:10.1097/ADM.0b013e318156c26f
Ahmed S, Stanciu CN, Kotapati PV, et al. Effectiveness of Gabapentin in Reducing Cravings and Withdrawal in Alcohol Use Disorder: A Meta-Analytic Review. Prim Care Companion CNS Disord. 2019;21(4):19r02465. Published 2019 Aug 22. doi:10.4088/PCC.19r02465
Uchitel OD, Di Guilmi MN, Urbano FJ, Gonzalez-Inchauspe C. Acute modulation of calcium currents and synaptic transmission by gabapentinoids. Channels (Austin). 2010;4(6):490-496. doi:10.4161/chan.4.6.12864
Fink K, Meder W, Dooley DJ, Göthert M. Inhibition of neuronal Ca(2+) influx by gabapentin and subsequent reduction of neurotransmitter release from rat neocortical slices. Br J Pharmacol. 2000;130(4):900-906. doi:10.1038/sj.bjp.0703380
Cunningham MO, Woodhall GL, Thompson SE, Dooley DJ, Jones RS. Dual effects of gabapentin and pregabalin on glutamate release at rat entorhinal synapses in vitro. Eur J Neurosci. 2004;20(6):1566-1576. doi:10.1111/j.1460-9568.2004.03625.x
Connie Y. Chang, Chaitanya K. Challa, Janki Shah, Jean Daniel Eloy, "Gabapentin in Acute Postoperative Pain Management", BioMed Research International, vol. 2014, Article ID 631756, 7 pages, 2014. https://doi.org/10.1155/2014/631756
Ghaffarpour M, Pakdaman H, Harirchian MH, et al. Pharmacokinetic and pharmacodynamic properties of the new AEDs: A review article. Iran J Neurol. 2013;12(4):157-165.
Roberto M, Gilpin NW, O'Dell LE, et al. Cellular and behavioral interactions of gabapentin with alcohol dependence. J Neurosci. 2008;28(22):5762-5771. doi:10.1523/JNEUROSCI.0575-08.2008
Koob GF. A role for brain stress systems in addiction. Neuron. 2008;59(1):11-34. doi:10.1016/j.neuron.2008.06.012
Eroglu C, Allen NJ, Susman MW, et al. Gabapentin receptor alpha2delta-1 is a neuronal thrombospondin receptor responsible for excitatory CNS synaptogenesis. Cell. 2009;139(2):380-392. doi:10.1016/j.cell.2009.09.025
Katsura M, Shibasaki M, Hayashida S, Torigoe F, Tsujimura A, Ohkuma S. Increase in expression of alpha1 and alpha2/delta1 subunits of L-type high voltage-gated calcium channels after sustained ethanol exposure in cerebral cortical neurons. J Pharmacol Sci. 2006;102(2):221-230. doi:10.1254/jphs.fp0060781
Prisciandaro JJ, Hoffman M, Brown TR, et al. Effects of Gabapentin on Dorsal Anterior Cingulate Cortex GABA and Glutamate Levels and Their Associations With Abstinence in Alcohol Use Disorder: A Randomized Clinical Trial. Am J Psychiatry. 2021;178(9):829-837. doi:10.1176/appi.ajp.2021.20121757
Bisaga A, Evans SM. The acute effects of gabapentin in combination with alcohol in heavy drinkers. Drug Alcohol Depend. 2006;83(1):25-32. doi:10.1016/j.drugalcdep.2005.10.008
Myrick, H., Malcolm, R., Randall, P., Boyle, E., Anton, R., Becker, H., & Randall, C. (2009). A double-blind trial of gabapentin versus lorazepam in the treatment of alcohol withdrawal.. Alcoholism, clinical and experimental research, 33 9, 1582-8 . https://doi.org/10.1111/j.1530-0277.2009.00986.x.
Brower, K., Kim, H., Strobbe, S., Karam-Hage, M., Consens, F., & Zucker, R. (2008). A randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia.. Alcoholism, clinical and experimental research, 32 8, 1429-38 . https://doi.org/10.1111/j.1530-0277.2008.00706.x.
Mason BJ, Quello S, Goodell V, Shadan F, Kyle M, Begovic A. Gabapentin treatment for alcohol dependence: a randomized clinical trial. JAMA Intern Med. 2014;174(1):70-77. doi:10.1001/jamainternmed.2013.11950
Falk DE, Ryan ML, Fertig JB, et al. Gabapentin Enacarbil Extended-Release for Alcohol Use Disorder: A Randomized, Double-Blind, Placebo-Controlled, Multisite Trial Assessing Efficacy and Safety. Alcohol Clin Exp Res. 2019;43(1):158-169. doi:10.1111/acer.13917
Cundy KC, Sastry S, Luo W, Zou J, Moors TL, Canafax DM. Clinical pharmacokinetics of XP13512, a novel transported prodrug of gabapentin. J Clin Pharmacol. 2008;48(12):1378-1388. doi:10.1177/0091270008322909
Anton RF, Latham P, Voronin K, et al. Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial. JAMA Intern Med. 2020;180(5):728-736. doi:10.1001/jamainternmed.2020.0249
Litten RZ, Bradley AM, Moss HB. Alcohol biomarkers in applied settings: recent advances and future research opportunities. Alcohol Clin Exp Res. 2010;34(6):955-967. doi:10.1111/j.1530-0277.2010.01170.x
Mariani JJ, Pavlicova M, Basaraba C, et al. Pilot randomized placebo-controlled clinical trial of high-dose gabapentin for alcohol use disorder. Alcohol Clin Exp Res. 2021;45(8):1639-1652. doi:10.1111/acer.14648
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Radosław Zaucha, Magdalena Gajkiewicz, Małgorzata Zając, Julia Silldorff, Tomasz Fura, Marcin Dudek, Zuzanna Felińska, Oliwia Iszczuk, Stanisław Anczyk, Magdalena Jaskółka
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 394
Number of citations: 0
