title: Low-dose gabapentin as useful adjuvant to opioids for neuropathic cancer pain when combined with low-dose imipramine.
abstract: OBJECTIVE
  Painful neuropathic conditions of cancer pain often show little response to nonopioid and opioid analgesics but may be eased by antidepressants and anticonvulsants. Although gabapentin is effective in the treatment of neuropathic pain in patients with cancer, some patients experience intolerable side effects sufficient to warrant discontinuation. The aim of this study was to see whether low-dose gabapentin is effective in treating cancer-related neuropathic pain when combined with low-dose imipramine.
  
  
  METHODS
  Fifty-two cancer patients diagnosed as having neuropathic pain were allocated into four groups: G400-I group took gabapentin 200 mg and imipramine 10 mg every 12 h orally; G400 group took gabapentin 200 mg every 12 h orally; G800 group took gabapentin 400 mg every 12 h orally; I group took imipramine 10 mg every 12 h orally.
  
  
  RESULTS
  Low-dose gabapentin-imipramine significantly decreased the total pain score and daily paroxysmal pain episodes. Several patients developed mild adverse symptoms in the four groups, and three patients discontinued treatment due to severe adverse events in the G800 group.
  
  
  CONCLUSIONS
  Low-dose gabapentin-antidepressant combination with opioids was effective in managing neuropathic cancer pain without severe adverse effects.
authors.affiliation: Multidisciplinary Pain Centre, School of Medicine, Aichi Medical University, 21 Karimata, Nagakutecho, Aichigun, Aichi, 480-1195, Japan, arainon@aichi-med-u.ac.jp.
authors.forename: Young-Chang P
authors.initials: YC
authors.lastname: Arai
authors.forename: Takako
authors.initials: T
authors.lastname: Matsubara
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shimo
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Suetomi
authors.forename: Makoto
authors.initials: M
authors.lastname: Nishihara
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ushida
authors.forename: Kunio
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Chiharu
authors.initials: C
authors.lastname: Suzuki
authors.forename: Akiko
authors.initials: A
authors.lastname: Kinoshita
authors.forename: Miki
authors.initials: M
authors.lastname: Kondo
authors.forename: Satuki
authors.initials: S
authors.lastname: Matsubara
authors.forename: Ruiko
authors.initials: R
authors.lastname: Hayashi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tohyama
authors.forename: Kikuyo
authors.initials: K
authors.lastname: Nishida
authors.forename: Maki
authors.initials: M
authors.lastname: Arakawa
mesh_terms: D000368:Aged; D000588:Amines / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D000077206:Gabapentin; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D010147:Pain Measurement / Q000187:drug effects; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology*; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
chemical_list: D000588:Amines; D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000929:Antidepressive Agents, Tricyclic; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D007099:Imipramine