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Gabapentin as a mood stabiliser in the treatment of alcoholism-SAD-comorbidity
Background: Gabapentin is a promising drug in the treatment of bipolar disorders, especially with secondary alcohol dependence (1). Probably, seasonal affective disorder (SAD) is part of the bipolar spectrum (2), but commonly mood stabilisers are not used in its therapeutical management.
Case-report: We report on a 45 year old woman with alcohol dependence for many years and with a lot of unsuccessful attemps of abstinence. We could now find a typical symptomatology of SAD, measured by the SPAQ. A combination of Mirtazapin, Citalopram and light therapy could solely lead to partial remission and she had a relapse with alcohol drinking. Since an additional treatment with Gabapentin, she reports on well-being and can maintain abstinence.
Conclusions: Gabapentin supports the antidepressive strategies in the treatment of SAD in comorbidity with alcohol dependence. Its efficacy as a mood stabiliser is a further argument for the placement of SAD as a part of the bipolar spectrum.
References: (1) Perugi G et al. Effectiveness of adjunctive Gabapentin in resistant bipolar disorder: Is it due to anxious-alcohol abuse comorbidity? J Clin Psychopharmacol 2002;22:584–591. (2) Akiskal HS, Pinto O. The soft bipolar spectrum. In: Marneros A, Angst J (eds). Bipolar Disorders: 100 years after manic-depressive insanity. p 37–62. 2000 Kluwer Academic Publishers.