Outpatient Gabapentin Rarely Used for Approved Indications

Concomitant use of central nervous system-depressant drugs listed for 58.4 percent of off-label gabapentin visits

TUESDAY, Nov. 23, 2021 (HealthDay News) — Less than 1 percent of outpatient gabapentin use is for approved indications, and more than half of visits list concomitant central nervous system-depressant (CNS-D) medications, according to a study published in the November issue of Psychiatric Services.

Brianna Costales and Amie J. Goodin, Ph.D., from the University of Florida in Gainesville, examined off-label outpatient gabapentin use for psychiatric indications and concomitant CNS-D medication use for 5,732 adults using data from the National Ambulatory Medical Care Survey for 2011 to 2016.

The researchers found that 2.8 percent of visits between 2011 and 2016 listed gabapentin prescriptions. Less than 1 percent listed a U.S. Food and Drug Administration-approved indication. Overall, 5.3, 3.5, and 1.8 percent of off-label gabapentin visits listed a depressive disorder, anxiety disorder, and bipolar disorder, respectively. More than half (58.4 percent) of off-label gabapentin visits listed one or more concomitant CNS-D medications, most frequently antidepressants, opioids, and benzodiazepines (24.3, 22.9, and 17.3 percent, respectively). Most gabapentin visits were with primary care providers and other provider specialties (not primary care, neurology, or psychiatry; 34.9 and 48.1 percent).

“In light of recent safety warnings from the FDA, the high proportions of concomitant CNS-D use found in this study underline the need for future research on the efficacy and safety of gabapentin prescribed off label for the treatment of patients with psychiatric symptoms or conditions,” the authors write.