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13,14 Therefore, gabapentin monotherapy should not be used in severe AWS or in those with a history of AWS seizures or who are at risk for progression to severe AWS

For established cognitive support, the evidence-based options include aerobic exercise (strong evidence for cognitive benefits, especially executive function and processing speed), sleep optimization (critical for cognitive function), Mediterranean diet (modest evidence for cognitive protection over years), treating sleep apnea (significant cognitive improvements when this condition is addressed), treating depression (major cognitive effects when present), donepezil and other approved Alzheimer drugs (modest evidence-based effects in actual Alzheimer disease), and stimulants (well-established for ADHD)

Non-surgical preference: Those seeking minimally invasive options might prefer injectable treatment to avoid surgery

The primary outcome was change in overall symptoms, measured using standardized rating scales such as the YaleBrown Obsession Compulsion Scale [16], the Massachusetts General Hospital Hair Pulling Scale [17], and the YaleBrown ObsessiveCompulsive Scale Modified for Neurotic Excoriation [18]

Askarpour M, Hadi A, Miraghajani M, Symonds ME, Sheikhi A, Ghaedi E