As a PMHNP, I would do a medical reconciliation first, to make sure that the patients comorbidities are being addressed because gabapentin is used adjunctively and is not FDA approved for bipolar disorder. Although gabapentin is mostly prescribed for patients who experience neuropathic pain. gabapentin is FDA approved for focal seizures, neuropathic pain, fibromyalgia, and post herpetic neuralgia (Cafer, 2020). However, Gabapentin is also prescribed for off label uses such as generalized anxiety, social anxiety, alcohol dependence and alcohol or benzo withdrawal (Cafer, 2020). As mentioned in the scenario, Gabapentin is sometimes used adjunctively for bipolar disorder, research studies have shown that it has very little if any mood stabilizing efficacy but it does have anxiolytic properties. As a PMHNP, no I would not prescribe gabapentin because it has proven to have very little affect on mood. However, if the patient is experiencing chronic pain then I would refer them to their PCP or NP.
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