Skip to main content

Gabapentin

  • Chapter
Antiepileptic Drugs

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 138))

Abstract

Gabapentin (“Neurontin”) has been shown in extensive preclinical and clinical studies to be an effective anticonvulsant drug, which appears to have novel mechanisms of action. Although designed as a GABA analogue it is clearly not GABAmimetic, although GABAergic mechanisms may be involved in its mechanisms of action. In clinical trials, gabapentin has shown efficacy in patients with refractory partial epilepsy. Because of its simple pharmacokinetic profile, minimal propensity for drug interactions, and lack of demonstrable or reported idiosyncratic reactions to date, the drug may have advantages in the treatment of epilepsy, when used as add-on therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Abou Khalil B, McLean M, Casiro O, Courville K (1990) Gabapentin in the treatment of refractory partial seizures. Epilepsia 31:644

    Google Scholar 

  • Abou Khalil B, Shellenberger MK, Anhut H (1992) Two open label multicentre studies of the safety and efficacy of gabapentin in patients with refractory partial epilepsy. Epilepsia 33 [Suppl 3]:77

    Google Scholar 

  • Albright PS, Burnham WM (1980) Development of a new pharmacological seizure model: effects of anticonvulsants on cortical and amygdala-kindled seizures in the rat. Epilepsia 21:681–6

    Article  PubMed  CAS  Google Scholar 

  • Anhut H, Leppik I, Schmidt B, Thomann P (1988) Drug interaction study on the new anticonvulsant gabapentin with phenytoin in epileptic patients. Naunyn-Schmiedeberg’s Arch Pharmacol 337 [Suppl]:29

    Google Scholar 

  • Anhut H, Ashman P, Feuerstein TJ, Sauerrnann W, Saunders M, Schmidt B (1994) Gabapentin (Neurontin) as add-on therapy in patients with partial seizures: a double-blind, placebo controlled study. The International Gabapentin Study Group. Epilepsia 35:795–801

    Article  PubMed  CAS  Google Scholar 

  • Arnett JL, Dodrill CB (1995) Effects of gabapentin (GBP, Neurontin) on cognitive functioning and mood. Epilepsia 38 [Suppl 3]:S32

    Google Scholar 

  • Bartoszyk GD, Hamer M (1987) The genetic animal model of reflex epilepsy in the mongolian gerbil: differential efficacy of new anticonvulsive drugs and prototype antiepileptics. Pharmacol Res Commun 19:429–440

    Article  PubMed  CAS  Google Scholar 

  • Bartoszyk GD, Fritschi E, Herrmann M, Satzinger G (1983) Indications for an involvement of the GABA-system in the mechanism of action of gabapentin. Naunyn-Schmiedeberg’s Arch Pharmacol 322:94

    Google Scholar 

  • Bartoszyk GD, Meyerson N, Reimann W, Satzinger G, von Hodenberg A (1986) Gabapentin. In: Meldrum BS, Porter RJ (eds) New anticonvulsant drugs. Libbey, London, pp. 147–164

    Google Scholar 

  • Bauer G, Bechinger D, Castell X et al. (1989) Gabapentin in the treatment of drug-resistant epileptic patients. In: Manelis J, Bental E, Loeber JN, Dreifuss FE (eds) XVIIth Epilepsy International Symposium. Raven Press, New York, Advances in Epileptology 17:219–221

    Google Scholar 

  • Ben-Menachem E, Hedner T, Persson LI, Soderfeldt H (1990) Seizure frequency and CSF gabapentin, GABA, and monoamine metabolite concentrations after 3 months’ treatment with 900 mg or 1,200mg gabapentin daily in patients with intractable complex partial seizures. Neurology 40 [Suppl 1]:158

    Google Scholar 

  • Ben-Menachem E, Persson LI, Hedner T (1992) Selected CSF biochemistry and gabapentin concentrations in the CSF and plasma in patients with partial seizures after a single oral dose of gabapentin. Epilepsy Res 11:45–49

    Article  PubMed  CAS  Google Scholar 

  • Boyd RA, Bockbrader HN, Türck D, Sedman AJ, Posvar EL, Chang T (1990) Effect of subject age on the single dose pharmacokinetics of orally administered gabapentin (CI-945). Pharm Res 7 [Suppl 9]:S215

    Google Scholar 

  • Browne T, and the Gabapentin Study Groups (1993) Long-term efficacy and toxicity of gabapentin. Neurology 43:A307

    Google Scholar 

  • Busch JA, Radulovic LI, Bockbrader HN, Underwood BA, Sedman AJ, Chang T (1992) Effect of Maalox TC® on single-dose pharmacokinetics of gabapentin capsules in healthy subjects. Pharm Res 9 [Suppl 10]:S315

    Google Scholar 

  • Chadwick D (1991) Gabapentin. In: Pisani F, Perucca E, Avanzini G, Richens A (eds) New antiepileptic drugs. Elsevier, Amsterdam, pp. 183–186

    Google Scholar 

  • Chadwick D (1994) Gabapentin. Lancet 343:89–91

    Article  PubMed  CAS  Google Scholar 

  • Chapman AG, Croucher MJ, Meldrum BS (1984) Evaluation of anticonvulsant drugs in DBA/2 mice with sound-induced seizures. Arzneimittel-Forsch 34: 1261–1264

    CAS  Google Scholar 

  • Comstock TI, Sica DA, Bockbrader HN, Underwood BA, Sedman AJ (1990) Gabapentin pharmacokinetics in subjects with various degrees of renal function. J Clin Pharmacol 30:862

    Google Scholar 

  • Crawford P, Ghadiali E, Lane R, Blumbardt I, Chadwick D (1987) Gabapentin as an antiepileptic drug in man. J Neurol Neurosurg Psychiatry 50:682–686

    Article  PubMed  CAS  Google Scholar 

  • Desmedt LKC, Niemegeers CJE, Lewi PJ, Janssen PAJ (1976) Antagonism of maximal metrazol seizures in rats and its relevance to an experimental classification of antiepileptic drugs. Arzneimittel-Forsch 26:1592–1603

    CAS  Google Scholar 

  • Dodrill CB, Wilensky AJ, Ojemann LM, Temkin NR, Shellenberger K (1992) Neuropsychological, mood, and psychosocial effects of gabapentin. Epilepsia 33 [Suppl 3]:117

    Google Scholar 

  • Dooley DJ, Bartoszyk GD, Hartensein J, Reimann W, Rock DM, Satzinger G (1986) Preclinical pharmacology of gabapentin. In: Golden Jubilee Conference and Northern European Epilepsy Meeting (University of York) Abstract 8

    Google Scholar 

  • Eldon MA, Underwood BA, Randinitis EJ, Posvar EL, Sedman AJ (1993) Lack of effect of gabapentin on the pharmacokinetics of a norethidrone acetate/ethinyl oestradiol containing oral contraceptive. Neurology 43 [Suppl 4]:A307-A308

    Google Scholar 

  • Fischer JH, Barr AN, Rogers SL, Fischer PA, Trudeau VL (1994) Lack of serious toxicity following gabapentin overdose. Neurology 44:982–983

    PubMed  CAS  Google Scholar 

  • Foot M, Wallace J (1991) Gabapentin. In: Pisani F, Perucca E, Avanzani G, Richens A (eds) New antiepileptic drugs. Elsevier, Amsterdam, pp. 109–114

    Google Scholar 

  • Gee NS, Brown JP, Dissanayake VUK, Offord J, Thurlow R, Woodruff GN (1996) The novel anticonvulsant drug gabapentin (Neurontin) binds to the 2delta subunit of a Ca++ channel. J Biol Chem 271:5768–5776

    Article  PubMed  CAS  Google Scholar 

  • Goa KL, Sorkin EM (1993) Gabapentin: a review of its pharmacological properties and clinical potential in epilepsy. Drugs 46:409–427

    Article  PubMed  CAS  Google Scholar 

  • Goldlust A, Su T-Z, Welty De Taylor CP, Oxender DL (1995) Effects of anticonvulsant drug gabapentin on the enzymes in metabolic pathways of glutamate and GABA. Epilepsy Res 22:1–11

    Article  PubMed  CAS  Google Scholar 

  • Graves NM, Holmes GB, Leppik E, Rask C, Slavin M, Anhut H (1989) Pharmacokinetics of gabapentin in patients treated with phenytoin. Pharmacotherapy 9: 196

    Google Scholar 

  • Graves NM, Leppik IE, Wagner ML, Spencer MM, Erdman GR (1990) Effect of gabapentin on carbamazepine levels. Epilepsia 31:644–645

    Google Scholar 

  • Haas HI, Wieser HG (1986) Gabapentin: action on hippocampal slices of the rat and effects in human epileptics. Proceedings of the Golden Jubilee Conference and Northern Europe Epilepsy Meeting. York, Abstract 9

    Google Scholar 

  • Haltenson CE, Keane WF, Turck D, Bockbrader HN, Eldon MA et al. (1992) Disposition of gabapentin (GAB) in hemodialysis (HD) patients. J Clin Pharmacol 32: 751

    Google Scholar 

  • Hengy H, Kölle EU (1985) Determination of gabapentin in plasma and urine by high-performance liquid chromatography and pre-column labelling for ultraviolet detection. J Chromatogr 341:473–478

    Article  PubMed  CAS  Google Scholar 

  • Hill DR, Suman-Chahaun N, Woodruff GN (1993) Localization of [3H]gabapentin to a novel site in rat brain: autoradiographic studies. Europ J Pharmacol — Molec Pharmacol Section 244:303–309

    Article  CAS  Google Scholar 

  • Honmou O, Kocsis JD, Richerson GB (1995a) Gabapentin potentiates the conductance increase induced by nipecotic acid in CA1 pyramidal neurons in vitro. Epilepsy Res 20:193–202

    Article  PubMed  CAS  Google Scholar 

  • Honmou O, Oyelese AA, Kocsis JD (1995b) The anticonvulsant gabapentin enhances promoted release of GABA in hippocampus: a field potential analysis. Brain Res 692:273–277

    Article  PubMed  CAS  Google Scholar 

  • Hooper WD, Kavanagh MC, Dickinson RB (1990) Determination of gabapentin in plasma and urine by capillary column gas chromatography. J Chromatog 529: 167–174

    Article  CAS  Google Scholar 

  • Hooper WD, Kavanagh MC, Herkes GK, Eadie MJ (1991) Lack of a pharmacokinetic interaction between phenobarbitone and gabapentin. Brit J Clin Pharmacol 31: 171–174

    CAS  Google Scholar 

  • Kocsis JD, Honmou O (1994) Gabapentin increases GABA-induced depolarization in rat neonatal optic nerve. Neurosci Lett 169:181–184

    Article  PubMed  CAS  Google Scholar 

  • Kondo T, Fromm GH, Schmidt B (1991) Comparison of gabapentin with other antiepileptic and GABAergic drugs. Epilepsy Res 8:226–231

    Article  PubMed  CAS  Google Scholar 

  • Leiderman D, Koto E, Lamoreaux L (1993) Gabapentin therapy and quality of life: side effects in placebo-controlled studies. Epilepsia 34 [Suppl 6]:45

    Google Scholar 

  • Löscher W, Frey HH (1984) Evaluation of anticonvulsant drugs in gerbils with reflex epilepsy. Arzneimittel-Forsch 34:1484–1488

    Google Scholar 

  • Löscher W, Frey HH, Reiche R, Schultz D (1983) High anticonvulsant potency of γ-aminobutyric acid (GABA) mimetic drugs in gerbils with genetically determined epilepsy. J Pharmacol Exp Ther 226:839–844

    PubMed  Google Scholar 

  • Löscher W, Honack D, Taylor CP (1991) Gabapentin increases aminooxyacetic acid-induced GABA accumulation in several regions of rat brain. Neurosci Lett 128: 150–154

    Article  PubMed  Google Scholar 

  • Loskota WJ, Lomax P, Rich ST (1974) The gerbil as a model for the study of epilepsies. Epilepsia 15:109–119

    Article  PubMed  CAS  Google Scholar 

  • McLean MJ (1994) Clinical pharmacokinetics of gabapentin. Neurology 44 [Suppl 5]:S17–S22

    PubMed  CAS  Google Scholar 

  • McLean MJ (1995) Gabapentin. Epilepsia 36 [Suppl 2]:S73–S85

    Article  CAS  Google Scholar 

  • Meldrum B, Horton R (1978) Blockade of epileptic responses in the photosensitive baboon, Papio papio, by two irreversible inhibitors of GABA-transaminase, γ-acetylenic GABA (4amino-hex-5-ynoic acid) and γ-vinyl GABA (4-amino-5-enoic acid). Psychopharmacol 59:47–50

    Article  CAS  Google Scholar 

  • Meldrum BS (1986) Preclinical test systems for evaluation of novel compounds. In: Meldrum BS, Porter RJ (eds) New anticonvulsant drugs. Libbey, London, pp. 31–48

    Google Scholar 

  • Naritaku DK, Stryker MT, Mecozzi LB, Copley CA, Faingold CL (1988) Gabapentin reduces the severity of audiogenic seizures in the genetically epilepsy-prone rat. Epilepsia 29:693

    Google Scholar 

  • Ojemann LM, Friel PH, Ojemann GA (1988) Gabapentin concentration in human brain. Epilepsia 29:694

    Google Scholar 

  • Ojemann LM, Wilensky AJ, Temkin NR, Chmelir T, Ricker RA, Wallace J (1992) Long-term treatment with gabapentin for partial epilepsy. Epilepsy Res 13: 159–165

    Article  PubMed  CAS  Google Scholar 

  • Pullman B, Berthod J (1975) Molecular orbital studies in the confirmation of GABA. Theoret Chim Acta 36:317–328

    Article  CAS  Google Scholar 

  • Reimann W (1983) Inhibition by GABA, baclofen and gabapentin of dopamine release from rabbit caudate nucleus: are there common or different sites of action? Eur J Pharmacol 94:341–344

    Article  PubMed  CAS  Google Scholar 

  • Richens A (1993) Clinical pharmacokinetics of gabapentin. In: Chadwick D (ed) New trends in epilepsy management: the role of gabapentin. Royal Society of Medicine Services, London, pp. 41–46

    Google Scholar 

  • Rock DM, Kelly KM, Macdonald RL (1993) Gabapentin actions on ligand and voltage-gated responses in cultured rodent neurons. Epilepsy Res 16:89–98

    Article  PubMed  CAS  Google Scholar 

  • Rogawski MA, Porter RJ (1990) Antiepileptic drugs: pharmacological mechanisms and clinical efficacy with consideration of promising developmental stage compounds. Pharmacol Rev 42:223–286

    PubMed  CAS  Google Scholar 

  • Schear MJ, Wiener JA, Rowan AJ (1991) Long-term efficacy of gabapentin in the treatment of partial seizures. Epilepsia 32 [Suppl 3]:6

    Google Scholar 

  • Schlicker E, Reimann W, Gother M (1985) Gabapentin decreases monoamine release without affecting acetylcholine release in the brain. Arzneimittel Forsch 35: 1347–1349

    CAS  Google Scholar 

  • Schmidt B (1989) Potential antiepileptic drugs: gabapentin. In: Levy RH, Dreifuss FE, Mattson RH, Meldrum BS, Penry JK (eds) Antiepileptic drugs. 3rd edn. Raven Press, New York, pp. 925–935

    Google Scholar 

  • Shorvon SD (1996) Gabapentin in treatment of epilepsy. In: Shorvon S, Dreifuss F, Fish D, Thomas D (eds) Blackwell Science, Oxford, pp. 429–443

    Google Scholar 

  • Sivenius J, Kïlvïïnen R, Ylinen A et al. (1991) Double blind study of gabapentin the treatment of partial seizures. Epilepsia 32:539–542

    Article  PubMed  CAS  Google Scholar 

  • Stewart BH, Kugler AR, Thompson PR, Bockbrader HN (1993) A saturable transport mechanism in the intestinal absorption of gabapentin is the underlying cause of the lack of proportionality between increasing dose and drug levels in plasma. Pharmac Res 10:276–281

    Article  CAS  Google Scholar 

  • Su T-Z, Lunney B, Campbell G, Oxender DL (1995) Transport of gabapentin, a g-amino acid drug, by system L α-amino acid transporters: A comparative study in astrocytes, synaptosomes and CHO cells. J Neurochem 64:2125–2131

    Article  PubMed  CAS  Google Scholar 

  • Suman-Chauhan N, Webdale L, Hill DR, Woodruff GN (1993) Characterisation of [3H]gabapentin binding to a novel site in rat brain, homogenate binding studies. Eur J Pharmacol 244:293–301

    Article  PubMed  CAS  Google Scholar 

  • Taylor CP (1993) Mechanism of action of new anti-epileptic drugs. In: Chadwick D (ed) New trends in epilepsy management: the role of gabapentin. Royal Society of Medicine Services Ltd, London, pp. 13–40

    Google Scholar 

  • Taylor CP (1994) Emerging perspectives on the mechanism of action of gabapentin. Neurology 44 [Suppl 5]:S10–S16

    PubMed  CAS  Google Scholar 

  • Taylor CP, Vartanian MG, Yuen PW, Bigge C, Suman-Chauhan N, Hill DR (1993) Potent and stereospecific anticonvulsant activity of 3-isobutyl GABA relates to in vitro binding at a novel site labelled by tritiated gabapentin. Epilepsy 14:11–15

    Article  CAS  Google Scholar 

  • Thurlow RJ, Brown JP, Gee NS, Hill DR, Woodruff GN (1993) [3H]Gabapentin may label a system-L-like neutral amino acid carrier in brain. Eur J Pharm 247: 341–345

    Article  CAS  Google Scholar 

  • Trudeau V, Leiderman D, Garafalo E, La Moreaux L (1993) Gabapentin (Neurontin) in patients with absence seizures: two double blind placebo controlled studies. Epilepsia 34 [Suppl 6]:45

    Google Scholar 

  • Turck D, Vollmer KO, Bockbrader HN, Sedman A (1989) Dose-linearity of the new anticonvulsant gabapentin after multiple oral doses. Eur J Clin Pharmacol 36:A310

    Google Scholar 

  • Tyndel (1994) Interaction of gabapentin with other antiepileptics. Lancet 343:1363–1364

    Article  PubMed  CAS  Google Scholar 

  • UK Gabapentin Study Group (1990) Gabapentin in partial epilepsy. Lancet 335: 1114–1117

    Article  Google Scholar 

  • US Gabapentin Study Group No. 5 (1993) Gabapentin as add-on therapy in refractory partial epilepsy: a double-blind, placebo controlled, parallel-group study. Neurology 43:2292–2298

    Google Scholar 

  • Uthmann BM, Hammond EJ, Wilder BJ (1990) Absence of gabapentin and valproate interaction: an evoked potential and pharmacokinetic study. Epilepsia 31:645

    Article  Google Scholar 

  • Vollmer KO, von Hodenberg A, Kölle EU (1986) Pharmacokinetics and metabolism of gabapentin in rat, dog and man. Arzneimittel Forsch 36:830–839

    CAS  Google Scholar 

  • Vollmer KO, Anhut H, Thomann P, Wagner F, Jïhnchen D (1989) Pharmacokinetic model and absolute bioavailability of the new anticonvulsant gabapentin. In: Manelis J et al. (eds) Advances in epileptology, Raven Press, New York, 17: 209–211

    Google Scholar 

  • Vollmer KO, Turek D, Bockbrader HN et al. (1992) Summary of Neurontin (gabapentin) clinical pharmacokinetics. Epilepsia 33 [Suppl 3]:77

    Google Scholar 

  • Von Hodenberg A, Vollmer KO (1983) Metabolism of 14C-gabapentin in rat, dog and man. Naunyn-Schmiedeberg’s Arch Pharmacol 324:R74

    Google Scholar 

  • Wamil AW, McLean MJ (1994) Limitation by gabapentin of high frequency action potential firing by mouse central neurons in cell culture. Epilepsy Res 17:1–11

    Article  PubMed  CAS  Google Scholar 

  • Watkins JC, Evans RH (1981) Excitatory amino acid transmitters. Ann Rev Pharmacol Toxicol 21:165–204

    Article  CAS  Google Scholar 

  • Welty DF, Schielke GP, Vartanian MG, Taylor CP (1993) Gabapentin anticonvulsant action in rats: dizequilibrium with peak drug concentrations in plasma and brain microdialysate. Epilepsy Res 16:175–181

    Article  PubMed  CAS  Google Scholar 

  • Wiener JA, Schear MJ, Rowan AJ, Wallace JD (1990) Safety and effectiveness of gabapentin in the treatment of partial seizures. Epilepsia 31:3

    Google Scholar 

  • Wolf SA, Shinnar S, Kang H, Bailaban-Gil K, Moshe S (1994) Abstract. Epilepsia 35 [Suppl 8]:38

    Google Scholar 

  • Yuen AWC (1991) Lamotrigine. In: Pisani F, Perucca E, Avanzini G et al (eds) New antiepileptic drugs. Elsevier, New York, pp. 115–123

    Google Scholar 

  • Zaczek R, Coyle IT (1982) Excitatory amino acid analogues: neurotoxicity and seizures. Neuropharmacol 21:15–26

    Article  CAS  Google Scholar 

  • Zorumski CF, Lothman EW, Hatlelid JM (1982) Rapid kindling in the hippocampus. Soc Neurosci Abstr 8:287.26

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Vajda, F.J.E. (1999). Gabapentin. In: Eadie, M.J., Vajda, F.J.E. (eds) Antiepileptic Drugs. Handbook of Experimental Pharmacology, vol 138. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60072-2_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-60072-2_16

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64244-9

  • Online ISBN: 978-3-642-60072-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics