title: Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use.
abstract: The first two alpha2delta ligands - gabapentin (GBP) and pregabalin (PGB) - were initially synthesized as antiepileptics; however, they were later also found to be useful for the treatment of additional conditions. Areas covered: Relevant publications describing potential underlying mechanisms, clinical pharmacokinetics/pharmacokinetics, and clinical efficacy and safety of these drugs in various disease conditions were searched in PubMed and Scopus and included in this review. Expert commentary: GBP and PGB are effective for the treatment neuropathic pain, fibromyalgia and epilepsy; in addition, they may be useful for the reduction of postoperative pain. PGB is also effective for the treatment of generalized anxiety disorder and GBP for the treatment of restless legs syndrome. GBP may be considered a treatment option for pain associated with Guillain-Barré Syndrome and phantom limb and for the management of uremic pruritus. Mirogabalin (MGB), recently developed, is being investigated for the treatment of peripheral neuropathic pain and fibromyalgia, showing promising results in patients with diabetic peripheral neuropathy. Their most frequent adverse reactions are of neuropsychiatric nature and include fatigue, dizziness, sedation, somnolence, and ataxia; peripheral edema and weight gain are also frequently described. Pharmacokinetic interactions are scarce; however, pharmacodynamic interactions have been described in association with drugs with CNS-depressant effects.
authors.affiliation: a Instituto de Neurociencias y Centro de Investigación Biomédica, Universidad de Granada , Granada , Spain.
authors.forename: Elena P
authors.initials: EP
authors.lastname: Calandre
authors.affiliation: a Instituto de Neurociencias y Centro de Investigación Biomédica, Universidad de Granada , Granada , Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rico-Villademoros
authors.affiliation: a Instituto de Neurociencias y Centro de Investigación Biomédica, Universidad de Granada , Granada , Spain.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Slim
mesh_terms: D000588:Amines / Q000494:pharmacology / Q000627:therapeutic use; D001643:Bridged Bicyclo Compounds / Q000494:pharmacology / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000494:pharmacology / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D008024:Ligands; D009422:Nervous System Diseases / Q000188:drug therapy; D000069583:Pregabalin / Q000494:pharmacology / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000588:Amines; D001643:Bridged Bicyclo Compounds; D002121:Calcium Channel Blockers; D003509:Cyclohexanecarboxylic Acids; D008024:Ligands; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; C000598618:mirogabalin
keywords: Gabapentin; adverse reactions; alpha2delta ligands; clinical indications; drug interactions; mechanism of action; mirogabalin; pharmacokinetics; pregabalin