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Gabapentin, used to manage neuropathic pain disorders, is the most studied and used anticonvulsant for vulvodynia 4. Dosage can be increased over time from 300 mg total daily to a maximum dose of 3,600 mg daily (1,200 mg by mouth three times a day), and may need adjustment to avoid adverse effects. Gabapentin. There is a lot of good research out there on the topical use of gabapentin 2-6%. In a study that appeared in Obstetrics & gynecology in 2008, women with vulvodynia were treated with 2% to 6% gabapentin. Tricyclic antidepressants should be considered for the treatment of vulvodynia. Selective serotonin reuptake inhibitors and gabapentin (Neurontin) should be considered for symptomatic relief of For treating vulvodynia, gabapentin works by inhibiting pain signals that are sent from damaged neurons. The retrospective study that was published in Obstetrics and Gynecology showed that gabapentin cream was well tolerated and effective for women experiencing vulvodynia. Multiple treatments have been used for vulvodynia, in-cluding vulvar care measures; topical, oral, and injectable medications; biofeedback; physical therapy; low-oxalate diet and calcium citrate supplementation; and surgery (Figure 2). Newer treatments being used include acupunc-ture, hypnotherapy, nitroglycerin, and botulinum toxin. This new study showed that putting the Neurontin (Gabapentin) in a topical cream decreased pain by an average of 2/3, and decreased pain by over 50% in 80% of the women. The topical cream should be one that is not irritating when used vaginally. Twenty-five trials explored the use of oral and topical medications in the treatment of vulvodynia. Data Synthesis: Vulvodynia is a poorly understood disease with an unknown etiology. Oral tricyclic antidepressants and gabapentin continue to be the most commonly used treatments for vulvodynia pain. Evidence for oral gabapentin in vulvodynia remains limited yet promising with several studies reporting patient satisfaction and pain relief (22–25). A limiting factor of oral therapy is the frequent systemic adverse events reported, such as somnolence, dizziness, and peripheral edema, which topical application of gabapentin may circumvent Topical creams Topical lidocaine with 2–5% gel or cream is often tried in women with vulvodynia to reduce nociceptive sensitivity of the skin and mucous membranes and for desensitization of vestibular nerves . This can be applied overnight or even several times a day depending on the patient’s needs. Topical gabapentin 6% cream. Researchers evaluated the clinical efficacy and tolerability of topical gabapentin 6% cream, and found that after a minimum of 8 weeks of therapy, pain was significantly reduced and sexual function improved. Pelvic floor hypertonicity and vulvodynia are frequently present concomitantly. 31,32 Baclofen’s muscle relaxation actions and decreased adverse effect profile make it a feasible treatment option. 33,34 One study found baclofen an effective treatment when combined in a cream with amitriptyline. 27 Additionally, a case report used a compounded All were diagnosed with localized provoked vulvodynia, defined as superficial vulvar vestibular pain provoked by touch, and reported having experienced pain for over 5 years. Of these patients, 45 received gabapentin first and then placebo, and 44 received placebo first and then gabapentin. In a retrospective chart review, 28 gabapentin cream reduced vulvar pain in PV and generalized vulvodynia pre‐ to post‐treatment. Gabapentin cream must be obtained through a compounding pharmacy. Efficacy of gabapentin cream needs to be tested in future RCTs. We evaluated the efficacy of gabapentin, in an extended release formulation, in women diagnosed with localized provoked vulvodynia, defined as superficial vulvar vestibular pain that is provoked by touch, in a demographically diverse sample. Application of topical gabapentin (10% gel) significantly reduced allodynia and vulvodynia in a streptozotocin-induced diabetic neuropathic rat model . An analgesic effect was also observed in a rabbit model in which ocular pain was ameliorated following application of gabapentin eye drops ( 40 ). Alongside psychosocial interventions and physiotherapy, pharmacological treatment such as oral gabapentin are used in the treatment of vulvodynia. Topical formulations of gabapentin have shown promise in animal models and case reports investigating its use in other pain conditions. Vulvodynia means ongoing pain in the vulva (the female genital area) when there is Lidocaine cream and ointment can be bought without a Gabapentin. This is an Objective: To evaluate the clinical efficacy and tolerability of topical gabapentin in the treatment of women with vulvodynia. Methods: A retrospective study was designed to ascertain clinical responses to topical gabapentin. Gabapentin 6% Vaginal Gel, compounded at Bayview Pharmacy, offers customized relief for vulvodynia, vulvar vestibulitis, and more. Learn how it may help you today.
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