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These included: Expressive communication Personal and domestic daily living skills Interpersonal skills Play-leisure skills Coping social skills Other clinical improvements observed with B12 included improvements in: Sleep Gastrointestinal symptoms Hyperactivity Tantrums Nonverbal intellectual quotient Vision Eye contact Echolalia Stereotypy Anemia Nocturnal enuresis (bed wetting) Adverse events with B12 identified by meta-analysis included: Hyperactivity (11.9%) Irritability (3.4%) Trouble sleeping (7.6%) Aggression (1.8%) Worsening behaviors (7.7%) But adverse effects were generally few, mild, not serious, and not significantly different compared to placebo

Patients should be counseled to watch for excessive drowsiness, impaired coordination, and respiratory depression (particularly if opioids are also in the regimen, since gabapentin is a known respiratory-risk amplifier when combined with opioids) [5]

10.1152/ajpgi.00001.2006 Am J Physiol Gastrointest Liver Physiol

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