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Invited Commentary
January 2014

Gabapentin: A New Addition to the Armamentarium for Alcohol Dependence?

Author Affiliations
  • 1New York State Psychiatric Institute, Columbia University Medical Center, New York
JAMA Intern Med. 2014;174(1):78-79. doi:10.1001/jamainternmed.2013.11973

Anticonvulsants, a diverse class of medications, reduce neuronal excitability and prevent seizures, acting at a range of different molecular targets, including sodium channels, and the glutamate and γ-aminobutyric acid (GABA) systems. Beyond the prophylaxis of seizures, anticonvulsants have proven useful in a number of other disorders, including various chronic pain syndromes and bipolar and other mood disorders. There has been long-standing interest in anticonvulsants for the treatment of alcohol dependence. Studies of anticonvulsants, most commonly carbamazepine, for treatment of acute alcohol withdrawal began to emerge in the 1970s, based in part on the typical occurrence of seizures, as well as autonomic hyperactivity, during alcohol withdrawal. Anticonvulsants lack abuse potential, which is a desirable feature for treating alcohol dependence. The consensus is that anticonvulsants are useful adjuncts in the treatment of alcohol withdrawal but do not fully substitute for benzodiazepines, which remain the treatment of choice.1

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