Use of Gabapentin in Pain Management

Abstract

There have been many proposed uses for gabapentin, including midscapular pain secondary to radiation myelopathy, RSD, neuropathic pain, postherpetic neuralgia, and migraine prophylaxis. However, the published reports consist of a small number of patients and limited data. Limited data provided in published case reports do not allow adequate evaluation of expected adverse effects or efficacy. It is unclear whether gabapentin is more effective for a specific type of pain and how gabapentin may compare with placebo or other therapeutic alternatives. Therefore, randomized, double-blind, placebo-controlled, prospective studies are warranted to further elucidate gabapentin uses beyond what is recommended by the Food and Drug Administration. Gabapentin should only be considered for pain management after well-established therapies have failed to produce desired outcomes.

The neurobiology of skeletal pain

“…This data, along with data suggesting sensory nerve fibers are injured in OA and low back pain, suggests a component of malignant and non‐malignant skeletal pain can be neuropathic in origin (Ohtori et al ., ; Schaible, ). This, as well as the fact that several skeletal pains can be attenuated by gabapentin (Rosenberg et al ., ; Wetzel & Connelly, ), which is approved for the treatment of neuropathic pain, suggests that injury to sensory nerve fibers may play a role in several types of skeletal pain (Donovan‐Rodriguez et al ., ; Kurejova et al ., ).…”

Gabapentin for opioid-related myoclonus in cancer patients

“…It has been shown to have analgesic activity in patients with neuropathic pain. Moreover, anxiolytic-like and antinociceptive actions have been reported [6]. In a previous report, gabapentin was also shown to be effective in treating taxane-induced myalgias [5].…”

Pharmacological treatments for chronic non-malignant pain

“…Gabapentin has been reported in open trials to reduce the pain of neuropathic states such as diabetic neuropathy, multiple sclerosis, migraine, post-herpetic neuralgia, and reflex sympathetic dystrophy (Backonja et al, 1998;Houtchens et al, 1997;Rowbotham et al, 1998;Wetzel & Connelly, 1997). The mechanism of action of gabapentin may be related to binding with the alpha-2-delta subunit of voltage-dependent calcium channels (Field et al, 1997;Taylor et al, 1998).…”