gabapentin topical vulvodynia what is gabapentin neurontin used for

Topical medications that have been used include estradiol , capsaicin, atropine, testosterone, nitroglycerine, doxepin, amitriptyline, baclofen, and gabapentin. Unfortunately, there are few adequate trials assessing the efficacy or safety of these medications in women with vulvodynia. Since oral gabapentin is frequently used for neuropathic pain, Boardman et al 23 hypothesized that topical gabapentin could be effective in treating vulvodynia. Records were gathered of pre- and postmenopausal women diagnosed with localized or generalized vulvodynia over a 6-year period and were narrowed to those treated with topical gabapentin. 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. Topical agents should be used with caution to avoid the problem of irritancy. A trial of a local anaesthetic agent may be considered in all vulvodynia subsets. Grade of recommendation C; evidence level IV Although topical agents are commonly given to women with vulvodynia, few controlled studies have been done to deter-mine which are the most 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. these topical medications. Topical therapies not shown to benefit vulvodynia include topical corticoste roids, topical testosterone, and topical antifungal medications. Table 1. Topical Medications Used to Treat Vulvodynia Topical medication Dosage Side effectsa 5% lidocaine ointment Apply to skin as needed; dispense 30-g tube. 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. All 4 patients with vulvodynia had a positive response and the formulation was deemed to be safe.15 In a nonrandomized study by Boardman et al,39 35 patients were treated with topical gabapentin 2% to 6% cream 3 times daily for 8 weeks and tolerated the medication well. Eighty percent reported improvement in pain of at least 50%, and 29% had 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. 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. Vulvodynia National Topical Therapy for Vulvodynia By Lori Boardman, MD, ScM See VESTIBULITIS, page 7 Volume XI, Issue I Winter 2005 Vulvar Vestibulitis: Dual Sources of Pain? See TOPICAL, page 2 I By Martha Goetsch, MD, MPH Dr. Boardman is an associate professor in the Department of Obstetrics and Gynecology at Women and The most frequently used treatments are medications that may include antidepressants, anticonvulsants like orally administered gabapentin, and local anesthetics. Since vulvodynia is a chronic condition, treatment usually needs to be continued indefinitely. Many women prefer a treatment with less systemic effects like a gabapentin topical cream. Topical gabapentin cream was well-tolerated and associated with significant pain relief and improved sexual function in women with vulvodynia. 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 ). Choosing the proper vehicle for topical medications is important because creams contain more preservatives and stabilizers than ointments and often produce burning on application, whereas ointments are usually better tolerated. Women with vulvodynia should be assessed for pelvic floor dysfunction. 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. 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. Overall, the authors concluded that a combination of treatments, which included topical gabapentin, was best for addressing vulvodynia and quality of life, particularly in younger patients. Keevil et al. conducted a two-center survey in the UK to evaluate the efficacy and safety of topical gabapentin for vulvodynia . A total of 27 of 54 Tricyclic antidepressants should be considered for the treatment of vulvodynia. Selective serotonin reuptake inhibitors and gabapentin (Neurontin) should be considered for symptomatic relief of Alongside psychosocial interventions and physiotherapy, pharmacological treatment such as oral gabapentin are used in the treatment of vulvodynia. Topical formulations of gabapentin have shown

gabapentin topical vulvodynia what is gabapentin neurontin used for
Rating 5 stars - 587 reviews




Blog

Articles and news, personal stories, interviews with experts.

Video