There is little available information on anticonvulsant treatment of mania in elderly patients. Seven elderly patients, each in a manic episode, were treated with gabapentin. All 7 patients experienced improvement in manic symptoms, with minimal to no side effects. They received gabapentin in combination with antipsychotic medications, and in 1 case in combination with valproate. Gabapentin appears to be a safe and effective treatment in geriatric mania when combined with antipsychotic medications or valproate. Gabapentin appears to be well tolerated with no major adverse drug interactions or side effects in elderly manic patients. This case series suggests that controlled studies are warranted to examine gabapentin's efficacy and side effects, particularly as an adjunctive medication, in geriatric mania.