Gabapentin is a first line drug for the treatment of neuropathic pain in spinal cord injury.
METHODS
Prospective, randomized, double blind, placebo-controlled, crossover clinical trial.


OBJECTIVE
To determine the efficacy of gabapentin in the treatment of neuropathic pain related to spinal cord injury.


BACKGROUND
Neuropathic pain is initiated or caused by a primary lesion or dysfunction in the nervous system. Neuropathic pain associated with spinal cord injury is quite refractory, and current treatments are not effective. Gabapentin, an anticonvulsant, has become the first choice in the treatment of neuropathic pain. The place of gabapentin in the treatment of spinal cord injury-related neuropathic pain was questioned in only a few recent reports; however, they are retrospectively designed, nonstandardized, and uncontrolled studies, or involve a very small series of patients using less than optimum doses.


METHODS
A total of 18-week study period included a 4-week medication/placebo titration period. This was followed by a 4-week stable dosing period when the patients continued to receive maximum tolerated doses, a 2-week washout period, then a crossover of 4 weeks of medication/placebo titration, and another 4 weeks of stable dosing period. Twenty paraplegic patients (female/male: 7/13) with complete spinal cord injury at the thoracic and lumbar level, aged between 20 and 65 years, with neuropathic pain for more than 6 months were recruited for the study.


RESULTS
All patients completed the study. Gabapentin reduced the intensity as well as the frequency of pain, relieved all neuropathic pain descriptors except the itchy, sensitive, dull, and cold types, and improved the quality of life (P < 0.05).


CONCLUSIONS
Gabapentin can be added to the list of first-line medications for the treatment of chronic neuropathic pain in spinal cord injury patients. It is a promising new agent and offers advantages over currently available treatments.
Levendoglu
Funda
F
Department of Physical Medicine and Rehabilitation, Selçuk University, Meram School of Medicine, Konya, Turkey.
Ogün
Cemile O
CO
Ozerbil
Onder
O
Ogün
Tunç C
TC
Ugurlu
Hatice
H
D000085:Acetates / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000588:Amines; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003509:Cyclohexanecarboxylic Acids; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000150:complications / Q000188:drug therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D012890:Sleep / Q000187:drug effects; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin