Title: Fast Fact and Concept #49: Gabapentin for Neuropathic Pain
Author(s): Anita Kishore; Linda King
Gabapentin (Neurontin) is now widely used for neuropathic pain. Controlled clinical trials in diabetic neuropathy and postherpetic neuralgia show that gabapentin at 2400-3600 mg/day has an efficacy similar to the tricyclic antidepressants. Consistent, though less compelling clinical evidence supports its use for a variety of other neuropathic pain syndromes, including cancer pain syndromes, pain associated with HIV infection, chronic back pain and others. The exact mechanism and site of action of gabapentin is unknown. Its use for neuropathic pain has become widespread because it is generally well-tolerated, easily titrated, has few drug interactions, and does not require laboratory monitoring. However, cost may be a limiting factor for some patients.
Patients suitable for Neurontin should ideally have a clear neuropathic pain syndrome, characterized by sharp, shooting, lancinating and/or burning pain, in a nerve root (radicular) or stocking/glove distribution.
Copyright Notice: Users are free to download and distribute Fast Facts for educational purposes only. Citation for referencing. Fast Fact and Concept #49 Kishore A and King L. Gapapentin for neuropathic pain. September, 2001. End-of-Life Physician Education Resource Center www.eperc.mcw.edu.
Fast Facts and Concepts was originally developed as an end-of-life teaching tool by Eric Warm, MD, U. Cincinnati, Department of Medicine. See: Warm, E. Improving EOL care--internal medicine curriculum project. J Pall Med 1999; 2: 339-340.
Disclaimer: Fast Facts provide educational information, this information is not medical advice. Health care providers should exercise their own independent clinical judgment. Some Fast Fact information cites the use of a product in dosage, for an indication, or in a manner other than that recommended in the product labeling. Accordingly, the official prescribing information should be consulted before any such product is used.
Creation Date: 9/2001
Format: Handouts, Lecture Notes
Purpose: Instructional Aid, Self-Study Guide, Teaching
|Training: Fellows, 3rd/4th Year Medical Students, PGY1 (Interns), PGY2-6, Physicians in Practice|
|Specialty: Anesthesiology, Emergency Medicine, Family Medicine, General Internal Medicine, Geriatrics, Hematology/Oncology, Neurology, OB/GYN, Ophthalmology, Pulmonary/Critical Care, Pediatrics, Psychiatry, Surgery|
ACGME Competencies: Medical Knowledge
Keyword(s): Addiction, Chronic non-malignant pain, Controlled substance regulations, Pain, Pain assessment, Pain treatment
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