Gabapentin for the treatment of alcohol use disorder

Expert Opin Investig Drugs. 2018 Jan;27(1):113-124. doi: 10.1080/13543784.2018.1417383. Epub 2017 Dec 23.

Abstract

Alcohol misuse is the fifth leading risk factor for premature death and disability worldwide. Fewer than 10% of afflicted Americans receive pharmacological treatment for alcohol use disorder. Gabapentin is a calcium channel GABAergic modulator that is widely used for pain. Studies showing reduced drinking and decreased craving and alcohol-related disturbances in sleep and affect in the months following alcohol cessation suggest therapeutic potential for alcohol use disorder. Areas covered: Human laboratory and clinical studies assessing gabapentin for alcohol use disorder are reviewed. Data were obtained by searching for English peer-reviewed articles on PubMed, reference lists of identified articles, and trials registered on clinicaltrials.gov. Additionally, the mechanism of action of gabapentin specific to alcohol use disorder, and studies of gabapentin for alcohol withdrawal and non-alcohol substance use disorders are summarized. Expert opinion: Alcohol use disorder represents a challenge and large, unmet medical need. Evidence from single-site studies lend support to the safety and efficacy of gabapentin as a novel treatment for alcohol use disorder, with unique benefits for alcohol-related insomnia and negative affect, relative to available treatments. Proprietary gabapentin delivery systems may open a path to pivotal trials and registration of gabapentin as a novel treatment for alcohol use disorder.

Keywords: Alcoholism; alcohol use disorder; calcium channel/GABA modulator; clinical trial; craving; gabapentin; human laboratory study; insomnia; negative affect; pregabalin; protracted withdrawal.

Publication types

  • Review

MeSH terms

  • Alcohol Drinking / prevention & control*
  • Alcoholism / drug therapy*
  • Alcoholism / physiopathology
  • Amines / adverse effects
  • Amines / pharmacology
  • Amines / therapeutic use*
  • Animals
  • Calcium Channel Blockers / adverse effects
  • Calcium Channel Blockers / pharmacology
  • Calcium Channel Blockers / therapeutic use
  • Cyclohexanecarboxylic Acids / adverse effects
  • Cyclohexanecarboxylic Acids / pharmacology
  • Cyclohexanecarboxylic Acids / therapeutic use*
  • Gabapentin
  • Humans
  • Sleep Initiation and Maintenance Disorders / drug therapy
  • Sleep Initiation and Maintenance Disorders / etiology
  • Substance Withdrawal Syndrome / drug therapy
  • gamma-Aminobutyric Acid / adverse effects
  • gamma-Aminobutyric Acid / pharmacology
  • gamma-Aminobutyric Acid / therapeutic use*

Substances

  • Amines
  • Calcium Channel Blockers
  • Cyclohexanecarboxylic Acids
  • gamma-Aminobutyric Acid
  • Gabapentin