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.
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References
Abou Khalil B, McLean M, Casiro O, Courville K (1990) Gabapentin in the treatment of refractory partial seizures. Epilepsia 31:644
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
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
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
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
Arnett JL, Dodrill CB (1995) Effects of gabapentin (GBP, Neurontin) on cognitive functioning and mood. Epilepsia 38 [Suppl 3]:S32
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
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
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
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
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
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
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
Browne T, and the Gabapentin Study Groups (1993) Long-term efficacy and toxicity of gabapentin. Neurology 43:A307
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
Chadwick D (1991) Gabapentin. In: Pisani F, Perucca E, Avanzini G, Richens A (eds) New antiepileptic drugs. Elsevier, Amsterdam, pp. 183–186
Chadwick D (1994) Gabapentin. Lancet 343:89–91
Chapman AG, Croucher MJ, Meldrum BS (1984) Evaluation of anticonvulsant drugs in DBA/2 mice with sound-induced seizures. Arzneimittel-Forsch 34: 1261–1264
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
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
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
Dodrill CB, Wilensky AJ, Ojemann LM, Temkin NR, Shellenberger K (1992) Neuropsychological, mood, and psychosocial effects of gabapentin. Epilepsia 33 [Suppl 3]:117
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
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
Fischer JH, Barr AN, Rogers SL, Fischer PA, Trudeau VL (1994) Lack of serious toxicity following gabapentin overdose. Neurology 44:982–983
Foot M, Wallace J (1991) Gabapentin. In: Pisani F, Perucca E, Avanzani G, Richens A (eds) New antiepileptic drugs. Elsevier, Amsterdam, pp. 109–114
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
Goa KL, Sorkin EM (1993) Gabapentin: a review of its pharmacological properties and clinical potential in epilepsy. Drugs 46:409–427
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
Graves NM, Holmes GB, Leppik E, Rask C, Slavin M, Anhut H (1989) Pharmacokinetics of gabapentin in patients treated with phenytoin. Pharmacotherapy 9: 196
Graves NM, Leppik IE, Wagner ML, Spencer MM, Erdman GR (1990) Effect of gabapentin on carbamazepine levels. Epilepsia 31:644–645
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
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
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
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
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
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
Hooper WD, Kavanagh MC, Dickinson RB (1990) Determination of gabapentin in plasma and urine by capillary column gas chromatography. J Chromatog 529: 167–174
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
Kocsis JD, Honmou O (1994) Gabapentin increases GABA-induced depolarization in rat neonatal optic nerve. Neurosci Lett 169:181–184
Kondo T, Fromm GH, Schmidt B (1991) Comparison of gabapentin with other antiepileptic and GABAergic drugs. Epilepsy Res 8:226–231
Leiderman D, Koto E, Lamoreaux L (1993) Gabapentin therapy and quality of life: side effects in placebo-controlled studies. Epilepsia 34 [Suppl 6]:45
Löscher W, Frey HH (1984) Evaluation of anticonvulsant drugs in gerbils with reflex epilepsy. Arzneimittel-Forsch 34:1484–1488
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
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
Loskota WJ, Lomax P, Rich ST (1974) The gerbil as a model for the study of epilepsies. Epilepsia 15:109–119
McLean MJ (1994) Clinical pharmacokinetics of gabapentin. Neurology 44 [Suppl 5]:S17–S22
McLean MJ (1995) Gabapentin. Epilepsia 36 [Suppl 2]:S73–S85
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
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
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
Ojemann LM, Friel PH, Ojemann GA (1988) Gabapentin concentration in human brain. Epilepsia 29:694
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
Pullman B, Berthod J (1975) Molecular orbital studies in the confirmation of GABA. Theoret Chim Acta 36:317–328
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
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
Rock DM, Kelly KM, Macdonald RL (1993) Gabapentin actions on ligand and voltage-gated responses in cultured rodent neurons. Epilepsy Res 16:89–98
Rogawski MA, Porter RJ (1990) Antiepileptic drugs: pharmacological mechanisms and clinical efficacy with consideration of promising developmental stage compounds. Pharmacol Rev 42:223–286
Schear MJ, Wiener JA, Rowan AJ (1991) Long-term efficacy of gabapentin in the treatment of partial seizures. Epilepsia 32 [Suppl 3]:6
Schlicker E, Reimann W, Gother M (1985) Gabapentin decreases monoamine release without affecting acetylcholine release in the brain. Arzneimittel Forsch 35: 1347–1349
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
Shorvon SD (1996) Gabapentin in treatment of epilepsy. In: Shorvon S, Dreifuss F, Fish D, Thomas D (eds) Blackwell Science, Oxford, pp. 429–443
Sivenius J, Kïlvïïnen R, Ylinen A et al. (1991) Double blind study of gabapentin the treatment of partial seizures. Epilepsia 32:539–542
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
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
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
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
Taylor CP (1994) Emerging perspectives on the mechanism of action of gabapentin. Neurology 44 [Suppl 5]:S10–S16
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
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
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
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
Tyndel (1994) Interaction of gabapentin with other antiepileptics. Lancet 343:1363–1364
UK Gabapentin Study Group (1990) Gabapentin in partial epilepsy. Lancet 335: 1114–1117
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
Uthmann BM, Hammond EJ, Wilder BJ (1990) Absence of gabapentin and valproate interaction: an evoked potential and pharmacokinetic study. Epilepsia 31:645
Vollmer KO, von Hodenberg A, Kölle EU (1986) Pharmacokinetics and metabolism of gabapentin in rat, dog and man. Arzneimittel Forsch 36:830–839
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
Vollmer KO, Turek D, Bockbrader HN et al. (1992) Summary of Neurontin (gabapentin) clinical pharmacokinetics. Epilepsia 33 [Suppl 3]:77
Von Hodenberg A, Vollmer KO (1983) Metabolism of 14C-gabapentin in rat, dog and man. Naunyn-Schmiedeberg’s Arch Pharmacol 324:R74
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
Watkins JC, Evans RH (1981) Excitatory amino acid transmitters. Ann Rev Pharmacol Toxicol 21:165–204
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
Wiener JA, Schear MJ, Rowan AJ, Wallace JD (1990) Safety and effectiveness of gabapentin in the treatment of partial seizures. Epilepsia 31:3
Wolf SA, Shinnar S, Kang H, Bailaban-Gil K, Moshe S (1994) Abstract. Epilepsia 35 [Suppl 8]:38
Yuen AWC (1991) Lamotrigine. In: Pisani F, Perucca E, Avanzini G et al (eds) New antiepileptic drugs. Elsevier, New York, pp. 115–123
Zaczek R, Coyle IT (1982) Excitatory amino acid analogues: neurotoxicity and seizures. Neuropharmacol 21:15–26
Zorumski CF, Lothman EW, Hatlelid JM (1982) Rapid kindling in the hippocampus. Soc Neurosci Abstr 8:287.26
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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
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DOI: https://doi.org/10.1007/978-3-642-60072-2_16
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