GABAPENTIN AS AN ADDICTION TREATMENT: AN EVIDENCE- BASED STUDY Dimochristos Papadimitriou, Eleni Geraki, Georgios Nedelkos, Kyriakos Tsantekidis, Maria Mironidou- Tjouveleki A' Laboratory of Pharmacology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece.   Gabapentin, is a synthetic analogue of the neurotransmitter gamma-aminobutyric acid with anticonvulsant activity It appears to inhibit excitatory neuron activity. This agent also exhibits analgesic properties It has high lipid solubility, is not metabolized by the liver, has no protein binding, and doesn't possess the usual drug interactions It is used to treat partial seizures, amyotrophic lateral sclerosis and painful neuropathies, while it has other potential uses which include monotherapy of refractory partial seizure disorders, treatment of spasticity in multiple sclerosis tremor, mood disorders and attenuation of disruptive behaviors in dementia Its role in the treatment of various substance addictions is being studied for several years. The objective of this study is to review the efficacy of gabapentin in treating alcohol, cocaine, opioids, nicotine, methamphetamine and cannabis dependence in a clinical level COCAINE DEPENDANCE- STUDIES TREATMENT OUTCOME POS Raby W.N. et al 2004 Haney M. et al 2005 Hart CL et al 2004 NEG Reccoppa L. et al 2004 Berger S.P. et al 2005 Bisaga A. et al 2006 Hart C.L. et al 2007 (a) Hart C.L. et al 2007 (b) Gonzalez G. et al 2007 Mancino J.M. et al 2014 COCAINE Gabapentin has been used in several clinical studies as a monotherapy or a combination treatment against cocaine addiction with disappointing results, despite earlier indications It had no effect on craving or abstinence rates, thus did not affect the substance usage Did not decrease the subjective effects of cocaine usage Combined with sertraline negatively affected sertraline’s results OPIOID DEPENDANCE- STUDIES TREATMENT OUTCOME  POS Berger A. et al 2003 Kumar P. et al 2003 Freye E, et al 2004 Kheirabadi G.R. et al 2008 Salehi M. et al 2011 Sanders C.N. et al 2013 Moghadam S.M et al 2013 NEG OPIOIDS Gabapentin was tested against opioid addiction with positive results as a monotherapy or a combination treatment It reduces the usage and alleviates opioid withdrawal symptoms Decreased the feeling of pain and cold , yawning, diarrhea, dysphoria and muscle tension The effects of gabapentin seems to be dose-related ALCOHOL Gabapentin has been used in several clinical studies as a monotherapy or a combination treatment against alcohol addiction with promising results It prolongs the abstinence period, therefore reducing the risk of relapse due to the fact that it alleviates withdrawal symptoms Reduces insomnia and mood instability In combination with flumazenil or naltrexone a better treatment outcome was observed The effects of gabapentin appears to be dose-related ALCOHOL DEPENDANCE- STUDIES TREATMENT OUTCOME POS Karam-Hage et al 2003 Voris J. et al 2003 Bazil C.W. et al 2005 Mariani J.J. et al 2006 Furieri F.A. et al 2007 Malcolm R. et al 2007 Brower K.J. et al 2008 Mason B.J. et al 2009 Hugh Myrick et al 2009 Raymond F. Anton et al 2009 Mehrdal Salehi et al 2011 Raymond F. Anton et al 2011 Joseph P. Schacht et al 2011 Joseph P. Schacht et al 2013 Christopher J. Stock et al 2013 Barbara J. Mason et al 2014 NEG Bonnet U. et al 2003 Bisaga A. et al 2006 Myrick H. et al 2007 CANNABIS DEPENDANCE- STUDIES TREATMENT OUTCOME POS Mason B.J. et al 2012 NEG METHAMPHETAMINE DEPENDANCE- STUDIES TREATMENT OUTCOME POS Urschel H.C. et al 2007 NEG Ling W. et al 2012 NICOTINE DEPENDANCE- STUDIES TREATMENT OUTCOME POS Sood A. et al 2007 NEG White W.D. et al 2005 Sood A. et al 2010 CANNABIS-METHAMPHETAMINE- NICOTINE Gabapentin significantly decreased withdrawal symptoms such as craving, sleep and mood disorders concerning cannabis dependence Was assessed twice combined with flumazenil and hydroxyzine against methamphetamine dependence . One research suggested that there was a substantial reduction in both usage and craving of methamphetamine while the other suggested that gabapentin was ineffective Regarding addiction to nicotine there were three studies with opposing results. One study suggested that gabapentin decreased the number of cigarettes per day and the abstinence rate but the other two studies suggested that gabapentin had no effect on smoking cessation and nicotine dependence. CONCLUSIONS Gabapentin was well tolerated with minor side effects even in the highest doses (3200 mg- cocaine addiction treatment) It holds promise as an effective treatment for alcohol and opioids addiction as a combination therapy or monotherapy, but it had no effect on cocaine dependence The effects appear to be dose- related Regarding cannabis, methamphetamine and nicotine dependence further research needs to be conducted due to the existence of little evidence