Gabapentin has a wide variety of uses but the main indications are for focal seizures in adults and children and for postherpatic neuralgia in adults. There are many commonly used off label indications such as for neuropathic pain, fibromyalgia, and alcohol dependence. Max dosing for gabapentin is around 3600 mg/day. Although the exact mechanism of action is unknown, it is clear that it is similar in chemical structure to GABA. This is important because GABA is responsible for modulating excitatory neurotransmitter release. Gabapentin is poorly protein bound at less than 3% and not metabolized. When discontinuing longer term therapies, doses should be tapered down over at least 7 days. Some of the most common side effects are dizziness, fatigue, and weight gain. The serious side effects are depression, suicidal thoughts and behaviors, and withdrawal related seizures.

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