[Gabapentin in the treatment of chronic intractable pain].
BACKGROUND
Gabapentin has been shown to reduce pain associated with diabetic neuropathia and postherpetic neuralgia. To date it is not known, whether gabapentin is generally effective in other types of pain. It was therefore the aim to study gabapentin in patients suffering from intractable pain with respect to efficacy, predictive factors and side effects.


METHODS
Retrospective analysis of the data sheet of pretreated patients suffering from intractable pain and treated with gabapentin as a third line drug at a university pain clinic. Pain intensity (visual analogue scale, VAS 0 -10 cm), pain characteristics, diagnosis, pre- and co-treatment, and side effects were assessed. Response to treatment was defined as a 50% reduction in pain or a pain intensity of VAS </= 3.


RESULTS
99 patients were included. Approximately half the patients (n = 49) responded to gabapentin. Patients suffering from neuropathic pain showed a higher response rate (60%) compared to patients with muscle-sceletal pain (35%). Allodynia was twice as high in the responders (35%) compared to the non-responders (18%) before treatment. No serious side effects were reported.


CONCLUSIONS
Gabapentin was effective in approximately 50% of pretreated patients with intractable pain. Neuropathic pain responded better than pain of other origine. Allodynia may be a predictive factor for a positive treatment effect.
Gustorff
B
B
Klinik für Allgemeine Intensivmedizin und Anästhesie, der Universität Wien, Germany.
Nahlik
G
G
Spacek
A
A
Kress
H G
HG
D000085:Acetates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000588:Amines; D000639:Amitriptyline / Q000008:administration & dosage / Q000627:therapeutic use; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D002220:Carbamazepine / Q000008:administration & dosage / Q000627:therapeutic use; D002908:Chronic Disease; D003509:Cyclohexanecarboxylic Acids; D004359:Drug Therapy, Combination; D000077206:Gabapentin; D006801:Humans; D000077213:Lamotrigine; D010148:Intractable Pain / Q000175:diagnosis / Q000188:drug therapy*; D010919:Placebos; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D014227:Triazines / Q000008:administration & dosage / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000639:Amitriptyline; D000700:Analgesics; D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002220:Carbamazepine; D003509:Cyclohexanecarboxylic Acids; D000077206:Gabapentin; D000077213:Lamotrigine; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors; D014227:Triazines; D005680:gamma-Aminobutyric Acid