title: Administration of four different doses of gabapentin reduces awakening from breakthrough pain and adverse effects in outpatients with neuropathic pain during the initial titration.
abstract: BACKGROUND
  Gabapentin is a safe and well-tolerated anticonvulsant with a wide therapeutic index, and it is used for neuropathic pain. The aim of this study was to compare previous dosing methods with the administration of four different doses of gabapentin while maintaining the same maximum daily dose for the safe administration of high doses of the medication.
  
  
  METHODS
  THE SUBJECTS WERE OUTPATIENTS WITH VARIOUS NEUROPATHIC PAIN SYNDROMES, WITH AT LEAST TWO OF THE FOLLOWING SYMPTOMS: allodynia, burning pain, shooting pain, or hyperalgesia. The TID group received equal doses of gabapentin 3 times per day, while the QID group received 4 different doses of gabapentin per day. The pain score, frequency of breakthrough pain (BTP), severity and the duration of pain, sleep disturbance due to nocturnal pain, and adverse effects were recorded each day.
  
  
  RESULTS
  The average daily pain score and sleep disturbance were significantly reduced in the QID group between days 3 and 10 of the experiment. The adverse effects of the medication were also reduced in the QID group. However, the frequency of BTP and severity and duration of pain were not significantly different between two groups.
  
  
  CONCLUSIONS
  Administration of 4 different doses of gabapentin during the initial titration in outpatients with neuropathic pain resulted in a significant reduction in awakening from breakthrough pain and a reduction in the adverse effects of the medication.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Ajou University College of Medicine, Suwon, Korea.
authors.forename: Jong-Yeun
authors.initials: JY
authors.lastname: Yang
authors.forename: Won Il
authors.initials: WI
authors.lastname: Lee
authors.forename: Woo-Kyung
authors.initials: WK
authors.lastname: Shin
authors.forename: Cheul Hong
authors.initials: CH
authors.lastname: Kim
authors.forename: Seong-Wan
authors.initials: SW
authors.lastname: Baik
authors.forename: Kyung-Hoon
authors.initials: KH
authors.lastname: Kim
keywords: Ambulatory care; Drug administration schedule; Gabapentin; Neuropathic pain
references.citation: Seizure. 2000 Jun;9(4):241-8
references.pmid: 10880282
references.citation: Life Sci. 2004 Apr 9;74(21):2605-10
references.pmid: 15041442
references.citation: JAMA. 1998 Dec 2;280(21):1837-42
references.pmid: 9846778
references.citation: Epilepsy Res. 1998 Jul;31(2):91-9
references.pmid: 9714500
references.citation: Clin Ther. 2003 Jan;25(1):81-104
references.pmid: 12637113
references.citation: Acta Anaesthesiol Taiwan. 2005 Jun;43(2):73-7
references.pmid: 16060401
references.citation: Clin Pharmacokinet. 1996 Jun;30(6):403-15
references.pmid: 8792055
references.citation: Clin Neuropharmacol. 2001 Jul-Aug;24(4):245-6
references.pmid: 11479399
references.citation: Epilepsia. 2002 Sep;43(9):983-92
references.pmid: 12199723
references.citation: Pain. 2002 Oct;99(3):557-566
references.pmid: 12406532
references.citation: Pain Med. 2007 Jan-Feb;8 Suppl 1:S3-7
references.pmid: 17280600
references.citation: Epilepsy Res. 2000 Jul;40(2-3):123-7
references.pmid: 10863139
references.citation: Pain. 2001 Nov;94(2):215-224
references.pmid: 11690735