Long-term use of gabapentin for treatment of pain after traumatic spinal cord injury.
OBJECTIVE
To determine the long-term efficacy of gabapentin as a treatment of pain after spinal cord injury.


METHODS
All patients with traumatic-onset spinal cord injury treated with gabapentin were identified and followed up using a longitudinal observational design with two contact points (6 and 36 months after the trial) using a semi-structured interview. The first follow-up interview attempted to capture all 31 patients placed on therapeutic trial. The second follow-up interview attempted to capture those reporting a favorable response (n = 14) to the therapeutic trial at the first follow-up.


RESULTS
Of the 27 patients contacted at the first follow-up (87% response rate), 6 (22%) discontinued the trial secondary to intolerable side effects; therefore, the pain analgesic effects of gabapentin in these patients could not be determined. Of the remaining 21 patients, 14 (67%) reported a favorable response (i.e., a 2 or greater point reduction on a 0-10 pain-rating scale). The second follow-up interview captured 11 (79% response rate) of the 14 patients reporting a favorable response at the first interview, and 91% (10 of 11 patients) continued to report that gabapentin was an effective analgesic. There was no evidence to suggest dosing difficulties due to tolerance over the 3-year period. Sedation, dizziness, and forgetfulness were the most common side effects.


CONCLUSIONS
Gabapentin may be an effective treatment of pain after spinal cord injury among those able to tolerate initial and long-term side effects.
Putzke
John David
JD
Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Richards
J Scott
JS
Kezar
Laura
L
Hicken
B L
BL
Ness
T J
TJ
D000085:Acetates / Q000008:administration & dosage*; D000588:Amines; D000700:Analgesics / Q000008:administration & dosage; D002908:Chronic Disease; D003509:Cyclohexanecarboxylic Acids; D005260:Female; D005500:Follow-Up Studies; D000077206:Gabapentin; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008137:Longitudinal Studies; D008297:Male; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement / Q000379:methods; D010264:Paraplegia / Q000150:complications; D013119:Spinal Cord Injuries / Q000150:complications*; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin