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In the current CADTH report four systematic reviews and one RCT assessed patients with neuropathic pain associated with a variety of conditions including fibromyalgia, chronic low back pain, mixed neuropathic pain, nerve injury pain, trigeminal neuralgia, and polyneuropathy. We included randomised, double‐blind trials of two weeks' duration or longer, comparing gabapentin (any route of administration) with placebo or another active treatment for neuropathic pain, with participant‐reported pain assessment. The purpose of this report is to review the clinical evidence on the efficacy, safety and guidelines for use of gabapentin in adults with neuropathic pain, and to examine evidence on the misuse or abuse of gabapentin and other drugs for neuropathic pain. Gabapentin provides pain relief of a high level in about a third of people who take if for painful neuropathic pain. Adverse events are frequent, but mostly tolerable. More conservative estimates of efficacy resulted from using better definitions of efficacy outcome at higher, clinically important, Gabapentin at doses of 1800 mg to 3600 mg daily (1200 mg to 3600 mg gabapentin encarbil) can provide good levels of pain relief to some people with postherpetic neuralgia and peripheral diabetic neuropathy. Introduction Gabapentin (Neurontin) is prescribed widely for conditions for which it has not been approved by regulators, including certain neuropathic pain conditions. There is limited evidence that gabapentin is safe and effective for the treatment of neuropathic pain. Published trial reports, and systematic reviews based on published trial reports, mislead patients and providers because Chronic Pain / drug therapy* Dose-Response Relationship, Drug Gabapentin / therapeutic use* Authors' conclusions: Gabapentin at doses of 1800 mg to 3600 mg daily (1200 mg to 3600 mg gabapentin encarbil) can provide good levels of pain relief to some people with postherpetic BACKGROUND: Gabapentin is commonly used to treat neuropathic pain (pain due to nerve damage). This review updates a review published in 2014, and previous reviews published in 2011, 2005 and 2000. OBJECTIVES: To assess the analgesic efficacy and adverse effects of gabapentin in chronic neuropathic pain in adults. Gabapentin at doses of 1800 mg to 3600 mg daily (1200 mg to 3600 mg gabapentin encarbil) can provide good levels of pain relief to some people with postherpetic neuralgia and peripheral diabetic neuropathy. Evidence for other types of neuropathic pain is very limited. Thirty-seven studies (5633 participants) studied oral gabapentin at daily doses of 1200 mg or more in 12 chronic pain conditions; 84% of participants were in studies of postherpetic neuralgia, painful diabetic neuropathy or mixed neuropathic pain. One, from the National Institute for Health and Care Excellence in the United Kingdom, includes the use of gabapentin as a first-tier treatment for all neuropathic pain. 14 Similarly, the European Moore RA, Wiffen PJ, Derry S, Toelle T, Rice AS. Gabapentin for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev. 2014;(4):CD007938. Study Population: Adults with postherpetic neuralgia or diabetic neuropathy Twenty-four systematic reviews or meta-analyses and one RCT met the inclusion criteria and provided data on efficacy and safety of gabapentin in patients with neuropathic pain. This Rapid Response Report, however, focused on four reports which provided either direct or indirect comparisons between gabapentin and active agents. In addition to being highly prevalent, neuropathic pain is problematic because it is difficult to treat, and only a minority of patients report adequate pain relief with currently available treatment modalities. 5. GABAPENTIN FOR CHRONIC NEUROPATHIC PAIN IN ADULTS (Wiffen et al., 2017) What Is the Aim of the Cochrane Review? This review updates parts of two earlier Cochrane reviews investigating effects of gabapentin in chronic neuropathic pain (pain due to nerve damage). Antiepileptic drugs are used to manage pain, predominantly for chronic neuropathic pain, especially when the pain is lancinating or burning. Gabapentin for chronic neuropathic pain and fibromyalgia in adults. Neuropathic pain is pain coming from damaged nerves. It differs from pain messages carried along healthy nerves from damaged tissue (a fall, cut, or arthritic knee). Neuropathic pain is treated by different medicines than pain from damaged tissue. Gabapentin for chronic neuropathic pain in adults. Bottom line. There is moderate‐quality evidence that oral gabapentin at doses of 1200 mg daily or more has an important effect on pain in some people with moderate or severe neuropathic pain after shingles or due to diabetes. Background. Neuropathic pain comes from damaged nerves. Clinical question: Is gabapentin associated with pain relief in people with chronic neuropathic pain? Bottom line: Oral gabapentin (1200-3600 mg/d for 4-12 weeks) for patients with moderate or severe neuropathic pain from postherpetic neuralgia (PHN) or painful diabetic neuropathy (PDN) is associated with pain reduction of at least 50% in 14% to 17% more patients than placebo. Gabapentin for chronic neuropathic pain in adults. Gabapentin for chronic neuropathic pain in adults Br J Community Nurs. 2019 Dec 2;24(12) :608-609.
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