Psychiatric Medications Program - Gabapentin

Generic Name / Strength / Form

gabapentin - Plan G coverage

Special Authority Criteria

Approval Period

Diagnosis of bipolar disorder
treatment failure or intolerance to lithium, valproate and carbamazepine.

Practitioner Exemptions

  • No practitioner exemptions

Special Notes

  • None

Special Authority Request Form(s)

Online Forms (PDF, 523KB)
Click on the link to complete a special authority request form.