New anticonvulsants: a review of applications for the management of substance abuse disorders.

Substance abuse and related disorders are a major problem in the United States and elsewhere. In many cases, pharmacotherapy has been shown to be useful in the treatment of substance abuse and related disorders, both in detoxification and in the prevention of relapse. However, currently used medications are not ideal, due either to their effectiveness being less than desirable or their side effect profiles being greater than desirable, or both. Medications with increased effectiveness or decreased side effects are needed. This article reviews three anticonvulsant medications, gabapentin, oxcarbazepine, and tiagabine, for possible utility in the treatment of substance abuse and related disorders. The following aspects of each medication are discussed: metabolism and kinetics, dosage and administration, possible interactions, side effects, and applications to substance abuse treatment; the last subject includes discussion of management of withdrawal symptoms, treatment of dual diagnosis, management of substance abuse sleep disorders, direct suppression of substance abuse/relapse prevention, and abuse potential. Each medication appears to have potential advantages for these uses, and further study of these medications in treatment of substance abuse disorders is recommended.