Low doses of gabapentin may be helpful in the management of chronic daily headache.
BACKGROUND
The difficult management of chronic daily headache and the lack of clinical trials for this medical condition led the authors to perform this study. Gabapentin has been successfully used for a variety of chronic pain conditions and therefore may be of use in the treatment of chronic headache.


OBJECTIVE
To assess the efficacy and safety of low doses of gabapentin in cases of chronic daily headache.


METHODS
Open-label study on a series of cases of chronic daily headache.


METHODS
Twenty-one consecutive patients with primary headache lasting 4 or more hours a day, at least 15 days per month, were invited to participate in this open trial. They were treated with low doses of gabapentin for sufficient time to lead to a headache-free period of at least 7 consecutive days. A minimum of 1 follow-up visit and 1 phone call were made in the subsequent 6-9 months.


METHODS
A simple "Patient Impression of Change" was used to evaluate the results. Patients were also invited to compare this treatment to previous ones, whenever possible.


RESULTS
The efficacy of the treatment with gabapentin was rated as "excellent" by 19% of the patients, "good" by 47.6%, "fair" by 19%, and "poor" by 14.4%.


CONCLUSIONS
Despite the inherent limitations of such a small open trial, the authors concluded that ratings of excellent and good by two thirds of this population of patients with chronic daily headache should encourage the setup of a large double-blind, multicentric, placebo-controlled trial of low doses of gabapentin for chronic daily headache.
Fragoso
Y D
YD
Universidade Federal de Sao Paulo, SP, Brazil.
Carrazana
E J
EJ
D000085:Acetates / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000588:Amines; D000700:Analgesics / Q000008:administration & dosage*; D002908:Chronic Disease; D003509:Cyclohexanecarboxylic Acids; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D000077206:Gabapentin; D006261:Headache / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin