Gabapentin treatment of impulsive-aggressive behaviour

Gabapentin is a relatively new antiepileptic agent structurally similar to gamma-aminobutyric acid (GABA), with unclear mechanisms of action and a good safety profile. It has been used in psychiatric practice, with promising results, for the treatment of several disorders (e.g. bipolar disorder, schizoaffective disorder, obsessive-compulsive disorder, social phobia, behavioral agitation in dementia). With regard to aggressive behavior, a few studies have reported significant improvement in symptoms among demented patients , while in one study it has been indicated a decrease in frequency and intensity of violent episodes in a young patient affected by intermittent explosive disorder, attention deficit hyperactivity disorder, organic mood disorder secondary to a closed head injury, simple partial seizure disorder after treatment with gabapentin (1200mg/day). We report a case of successful treatment of chronic impulsive aggressive behavior by using gababentin in a patient with severe borderline personality disorder.