(FDA approved in bold)

• Partial-onset seizures with and without secondary generalization (adjunctive for adults and children 12 and older)
  
• Partial-onset seizures in children 3 and older
  
• Pain associated with post-herpetic neuralgia
  
• Neuropathic pain
  
• Migraine prophylaxis
  
• Facial pain
  
• Allodynia and hyperalgesia
  
• Fibromyalgia
  
• Bipolar disorder
  
• Generalized anxiety disorder
  
• Alcohol and drug withdrawal
  
• Insomnia

• Structural analog of gamma-aminobutyric acid (GABA) which binds at the alpha-2-delta subunit of voltage-sensitive calcium channels and reduces calcium influx. Changes calcium channel function but not as a blocker
  
• Reduces release of excitatory neurotransmitters, and decreases brain glutamate and glutamine levels
  
• Increases plasma serotonin levels
  
• Inactive at GABA receptors and does not affect GABA uptake or degradation

• Seizures – 2 weeks
  
• Pain/Anxiety – days-weeks

• Seizures – goal is the remission of seizures. Continue as long as effective and well-tolerated. Consider tapering and slowly stopping after 2 years without seizures, depending on the type of epilepsy
  
• Pain – goal is reduction of pain. Usually reduces but does not cure pain and there is recurrence off the medication. Consider tapering for conditions that may improve over time, i.e., post-herpetic neuralgia or migraine

• Increase to highest tolerated dose
  
• Epilepsy: Consider changing to another agent, adding a second agent or referral for epilepsy surgery evaluation
  
• Pain: If not effective in 2 months, consider stopping or using another agent

• Epilepsy: No major drug interactions with other AEDs. Using in combination may worsen CNS side effects
  
• Neuropathic pain: Can use with tricyclic antidepressants, SNRIs, other AEDs or opiates to augment treatment response. Gabapentin usually decreases opiate use
  
• Anxiety: Usually used as an adjunctive agent with SSRIs, SNRIs, monoamine oxidase (MAO) inhibitors or benzodiazepines

• No regular blood tests are recommended