Gabapentin is FDA approved to treat epilepsy and neuropathic pain. There is no published meta-analysis of gabapentin for treating AUD, with the only peer-reviewed findings coming from three placebo-controlled RCTs (total N=231 patients).54 The largest of these trials (N=150) compared gabapentin 900 or 1800 mg/day with placebo for 12 weeks and showed a higher rate of abstinence in the low- and high-dose gabapentin groups [11.1% (95% CI=5.2–22.2) and 17.0% (95% CI=8.9–30.1], respectively, than placebo: 4.1% (95% CI=1.1–13.7). The placebo group had a lower rate of no binge drinking [22.5% (95% CI=13.6–37.2)] than either the gabapentin 900 mg/day [29.6% (95% CI=19.1–42.8) or 1800 mg/day [44.7% (95% CI=31.4–58.8)] groups.20 However, this study had a high dropout rate (43%), which could have biased the findings. Preliminary findings from a multi-center trial of enacarbil ER, a prodrug formulation, in 346 patients with moderate or severe AUD,55 showed no effect of gabapentin on either the primary outcome measure, percent of subjects with no binge drinking days (28.3 vs. 21.5 for gabapentin and placebo, respectively), or any other drinking measure.
