Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease

Michael Raymond Binder

doi:doi:10.11648/j.ajcem.20210904.15

| Peer-Reviewed

Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease

Michael Raymond Binder

Published in American Journal of Clinical and Experimental Medicine (Volume 9, Issue 4)

Received: 13 August 2021 Accepted: 24 August 2021 Published: 31 August 2021

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Abstract

Originally marketed under the brand name Neurontin, the anticonvulsant drug gabapentin has become one of the most widely prescribed—and one of the most controversial—drugs in America. On the market for nearly three decades, the drug has been prescribed for everything from chronic cough to chronic pain and hot flashes to bipolar disorder; but is it the real deal, or is it just the brain-child of aggressive marketing, false advertising, and wishful thinking? This critical review will dissect gabapentin down to its molecular roots and trace its wide-ranging effects to better understand the drug and the persons who use it. It will also discuss how gabapentin (and other anticonvulsant drugs) may be doing something more profound than just treating acute symptoms. An emerging hypothesis contends that psychiatric and related function symptoms are driven by pathological hyperactivity in symptom-related circuits in the brain and that the same abnormality may, over time, be driving the development of a plethora of general medical conditions, including diabetes, high blood pressure, cardiovascular disease, autoimmune diseases, dementia, and cancer. Emerging evidence suggests that the underlying physiological abnormality—an inherent hyperexcitability of the neurological system—is very common, and clinical correlation suggests that it is inherited in a classic autosomal dominant distribution. There is also evidence that the abnormality may be reflected in one’s resting vital signs, an observation that could help carriers identify the trait themselves. Gabapentin, together with other pharmacological (and non-pharmacological) interventions that reduce neuronal excitability, may, in addition to their immediate effects, have the potential to prevent the long-term erosive effects of neuronal hyperexcitability by simply turning down the stress response. Recognition of this could usher in history’s greatest campaign in the fight against sickness and disease.

Published in	American Journal of Clinical and Experimental Medicine (Volume 9, Issue 4)
DOI	10.11648/j.ajcem.20210904.15
Page(s)	122-134
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Gabapentin, Anticonvulsants, Neuronal Hyperexcitability, Genetics of Psychiatric Disorders, Ionchannelopathies, Biomarkers of Disease, Preventive Health Strategies

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Michael Raymond Binder. (2021). Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease. American Journal of Clinical and Experimental Medicine, 9(4), 122-134. https://doi.org/10.11648/j.ajcem.20210904.15

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Michael Raymond Binder. Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease. Am. J. Clin. Exp. Med. 2021, 9(4), 122-134. doi: 10.11648/j.ajcem.20210904.15

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Michael Raymond Binder. Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease. Am J Clin Exp Med. 2021;9(4):122-134. doi: 10.11648/j.ajcem.20210904.15

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@article{10.11648/j.ajcem.20210904.15,
  author = {Michael Raymond Binder},
  title = {Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {9},
  number = {4},
  pages = {122-134},
  doi = {10.11648/j.ajcem.20210904.15},
  url = {https://doi.org/10.11648/j.ajcem.20210904.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20210904.15},
  abstract = {Originally marketed under the brand name Neurontin, the anticonvulsant drug gabapentin has become one of the most widely prescribed—and one of the most controversial—drugs in America. On the market for nearly three decades, the drug has been prescribed for everything from chronic cough to chronic pain and hot flashes to bipolar disorder; but is it the real deal, or is it just the brain-child of aggressive marketing, false advertising, and wishful thinking? This critical review will dissect gabapentin down to its molecular roots and trace its wide-ranging effects to better understand the drug and the persons who use it. It will also discuss how gabapentin (and other anticonvulsant drugs) may be doing something more profound than just treating acute symptoms. An emerging hypothesis contends that psychiatric and related function symptoms are driven by pathological hyperactivity in symptom-related circuits in the brain and that the same abnormality may, over time, be driving the development of a plethora of general medical conditions, including diabetes, high blood pressure, cardiovascular disease, autoimmune diseases, dementia, and cancer. Emerging evidence suggests that the underlying physiological abnormality—an inherent hyperexcitability of the neurological system—is very common, and clinical correlation suggests that it is inherited in a classic autosomal dominant distribution. There is also evidence that the abnormality may be reflected in one’s resting vital signs, an observation that could help carriers identify the trait themselves. Gabapentin, together with other pharmacological (and non-pharmacological) interventions that reduce neuronal excitability, may, in addition to their immediate effects, have the potential to prevent the long-term erosive effects of neuronal hyperexcitability by simply turning down the stress response. Recognition of this could usher in history’s greatest campaign in the fight against sickness and disease.},
 year = {2021}
}

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TY  - JOUR
T1  - Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease
AU  - Michael Raymond Binder
Y1  - 2021/08/31
PY  - 2021
N1  - https://doi.org/10.11648/j.ajcem.20210904.15
DO  - 10.11648/j.ajcem.20210904.15
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 122
EP  - 134
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20210904.15
AB  - Originally marketed under the brand name Neurontin, the anticonvulsant drug gabapentin has become one of the most widely prescribed—and one of the most controversial—drugs in America. On the market for nearly three decades, the drug has been prescribed for everything from chronic cough to chronic pain and hot flashes to bipolar disorder; but is it the real deal, or is it just the brain-child of aggressive marketing, false advertising, and wishful thinking? This critical review will dissect gabapentin down to its molecular roots and trace its wide-ranging effects to better understand the drug and the persons who use it. It will also discuss how gabapentin (and other anticonvulsant drugs) may be doing something more profound than just treating acute symptoms. An emerging hypothesis contends that psychiatric and related function symptoms are driven by pathological hyperactivity in symptom-related circuits in the brain and that the same abnormality may, over time, be driving the development of a plethora of general medical conditions, including diabetes, high blood pressure, cardiovascular disease, autoimmune diseases, dementia, and cancer. Emerging evidence suggests that the underlying physiological abnormality—an inherent hyperexcitability of the neurological system—is very common, and clinical correlation suggests that it is inherited in a classic autosomal dominant distribution. There is also evidence that the abnormality may be reflected in one’s resting vital signs, an observation that could help carriers identify the trait themselves. Gabapentin, together with other pharmacological (and non-pharmacological) interventions that reduce neuronal excitability, may, in addition to their immediate effects, have the potential to prevent the long-term erosive effects of neuronal hyperexcitability by simply turning down the stress response. Recognition of this could usher in history’s greatest campaign in the fight against sickness and disease.
VL  - 9
IS  - 4
ER  -

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Michael Raymond Binder

North Shore University Health System, Highland Park Hospital, Highland Park, USA

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Michael Raymond Binder. (2021). Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease. American Journal of Clinical and Experimental Medicine, 9(4), 122-134. https://doi.org/10.11648/j.ajcem.20210904.15

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ACS Style

Michael Raymond Binder. Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease. Am. J. Clin. Exp. Med. 2021, 9(4), 122-134. doi: 10.11648/j.ajcem.20210904.15

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AMA Style

Michael Raymond Binder. Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease. Am J Clin Exp Med. 2021;9(4):122-134. doi: 10.11648/j.ajcem.20210904.15

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@article{10.11648/j.ajcem.20210904.15,
  author = {Michael Raymond Binder},
  title = {Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {9},
  number = {4},
  pages = {122-134},
  doi = {10.11648/j.ajcem.20210904.15},
  url = {https://doi.org/10.11648/j.ajcem.20210904.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20210904.15},
  abstract = {Originally marketed under the brand name Neurontin, the anticonvulsant drug gabapentin has become one of the most widely prescribed—and one of the most controversial—drugs in America. On the market for nearly three decades, the drug has been prescribed for everything from chronic cough to chronic pain and hot flashes to bipolar disorder; but is it the real deal, or is it just the brain-child of aggressive marketing, false advertising, and wishful thinking? This critical review will dissect gabapentin down to its molecular roots and trace its wide-ranging effects to better understand the drug and the persons who use it. It will also discuss how gabapentin (and other anticonvulsant drugs) may be doing something more profound than just treating acute symptoms. An emerging hypothesis contends that psychiatric and related function symptoms are driven by pathological hyperactivity in symptom-related circuits in the brain and that the same abnormality may, over time, be driving the development of a plethora of general medical conditions, including diabetes, high blood pressure, cardiovascular disease, autoimmune diseases, dementia, and cancer. Emerging evidence suggests that the underlying physiological abnormality—an inherent hyperexcitability of the neurological system—is very common, and clinical correlation suggests that it is inherited in a classic autosomal dominant distribution. There is also evidence that the abnormality may be reflected in one’s resting vital signs, an observation that could help carriers identify the trait themselves. Gabapentin, together with other pharmacological (and non-pharmacological) interventions that reduce neuronal excitability, may, in addition to their immediate effects, have the potential to prevent the long-term erosive effects of neuronal hyperexcitability by simply turning down the stress response. Recognition of this could usher in history’s greatest campaign in the fight against sickness and disease.},
 year = {2021}
}

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TY  - JOUR
T1  - Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease
AU  - Michael Raymond Binder
Y1  - 2021/08/31
PY  - 2021
N1  - https://doi.org/10.11648/j.ajcem.20210904.15
DO  - 10.11648/j.ajcem.20210904.15
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 122
EP  - 134
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20210904.15
AB  - Originally marketed under the brand name Neurontin, the anticonvulsant drug gabapentin has become one of the most widely prescribed—and one of the most controversial—drugs in America. On the market for nearly three decades, the drug has been prescribed for everything from chronic cough to chronic pain and hot flashes to bipolar disorder; but is it the real deal, or is it just the brain-child of aggressive marketing, false advertising, and wishful thinking? This critical review will dissect gabapentin down to its molecular roots and trace its wide-ranging effects to better understand the drug and the persons who use it. It will also discuss how gabapentin (and other anticonvulsant drugs) may be doing something more profound than just treating acute symptoms. An emerging hypothesis contends that psychiatric and related function symptoms are driven by pathological hyperactivity in symptom-related circuits in the brain and that the same abnormality may, over time, be driving the development of a plethora of general medical conditions, including diabetes, high blood pressure, cardiovascular disease, autoimmune diseases, dementia, and cancer. Emerging evidence suggests that the underlying physiological abnormality—an inherent hyperexcitability of the neurological system—is very common, and clinical correlation suggests that it is inherited in a classic autosomal dominant distribution. There is also evidence that the abnormality may be reflected in one’s resting vital signs, an observation that could help carriers identify the trait themselves. Gabapentin, together with other pharmacological (and non-pharmacological) interventions that reduce neuronal excitability, may, in addition to their immediate effects, have the potential to prevent the long-term erosive effects of neuronal hyperexcitability by simply turning down the stress response. Recognition of this could usher in history’s greatest campaign in the fight against sickness and disease.
VL  - 9
IS  - 4
ER  -

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