title: Gabapentinoids are effective in decreasing neuropathic pain and other secondary outcomes after spinal cord injury: a meta-analysis.
abstract: OBJECTIVE
  To examine the effectiveness of gabapentin and pregabalin in diminishing neuropathic pain and other secondary conditions in individuals with spinal cord injury (SCI).
  
  
  METHODS
  A systematic search was conducted using multiple databases for relevant articles published from 1980 to June 2013.
  
  
  METHODS
  Controlled and uncontrolled trials involving gabapentin and pregabalin for treatment of neuropathic pain, with ≥3 subjects and ≥50% of study population with SCI, were included.
  
  
  METHODS
  Two independent reviewers selected studies based on inclusion criteria and then extracted data. Pooled analysis using Cohen's d to calculate standardized mean difference (SMD), SE, and 95% confidence interval (CI) for primary (pain) and secondary outcomes (anxiety, depression, sleep interference) was conducted.
  
  
  RESULTS
  Eight studies met inclusion criteria. There was a significant reduction in the intensity of neuropathic pain at <3 months (SMD=.96±.11; 95% CI, .74-1.19; P<.001) and between 3 and 6 months (SMD=2.80±.18; 95% CI, 2.44-3.16; P<.001). A subanalysis found a significant decrease in pain with gabapentin (SMD=1.20±.16; 95% CI, .88-1.52; P<.001) and with pregabalin (SMD=1.71±.13; 95% CI, 1.458-1.965; P<.001). A significant reduction in other SCI secondary conditions, including sleep interference (SMD=1.46±.12; 95% CI, 1.22-1.71; P<.001), anxiety (SMD=1.05±.12; 95% CI, .81-1.29; P<.001), and depression (SMD=1.22±.13; 95% CI, .967-1.481; P<.001) symptoms, was shown. A significantly higher risk of dizziness (risk ratio [RR]=2.02, P=.02), edema (RR=6.140, P=.04), and somnolence (RR=1.75, P=.01) was observed.
  
  
  CONCLUSIONS
  Gabapentin and pregabalin appear useful for treating pain and other secondary conditions after SCI. Effectiveness comparative to other analgesics has not been studied. Patients need to be monitored closely for side effects.
authors.affiliation: Aging, Rehabilitation, and Geriatric Care, Lawson Health Research Institute, London, Ontario, Canada; University of Western Ontario, London, Ontario, Canada; St. Joseph's Parkwood Hospital, London, Ontario, Canada. Electronic address: swati.mehta@sjhc.london.on.ca.
authors.forename: Swati
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Aging, Rehabilitation, and Geriatric Care, Lawson Health Research Institute, London, Ontario, Canada; University of Western Ontario, London, Ontario, Canada; St. Joseph's Parkwood Hospital, London, Ontario, Canada.
authors.forename: Amanda
authors.initials: A
authors.lastname: McIntyre
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Marcel
authors.initials: M
authors.lastname: Dijkers
authors.affiliation: Aging, Rehabilitation, and Geriatric Care, Lawson Health Research Institute, London, Ontario, Canada; University of Western Ontario, London, Ontario, Canada; St. Joseph's Parkwood Hospital, London, Ontario, Canada.
authors.forename: Eldon
authors.initials: E
authors.lastname: Loh
authors.affiliation: Aging, Rehabilitation, and Geriatric Care, Lawson Health Research Institute, London, Ontario, Canada; University of Western Ontario, London, Ontario, Canada; St. Joseph's Parkwood Hospital, London, Ontario, Canada.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Teasell
mesh_terms: D000588:Amines / Q000009:adverse effects / Q000627:therapeutic use*; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D001007:Anxiety / Q000209:etiology; D002986:Clinical Trials as Topic; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D003863:Depression / Q000209:etiology; D000077206:Gabapentin; D006801:Humans; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D000069583:Pregabalin; D020919:Sleep Disorders, Intrinsic / Q000209:etiology; D013119:Spinal Cord Injuries / Q000150:complications*; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin
keywords: Pain; Rehabilitation; Spinal cord injuries