. Chapters 0:00 Introduction 0:21 Uses of Gabapentin 1:26 Dosage for Gabapentin 2:51 Side effects of Gabapentin 3:39 Warnings Gabapentin, sold under the brand name Neurontin among others, is an anticonvulsant medication primarily used to treat partial seizures and neuropathic pain.[3][6] It is a first-line medication for the treatment of neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central pain.[7] It is moderately effective: about 30–40% of those given gabapentin for diabetic neuropathy or postherpetic neuralgia have a meaningful benefit.[8] Sleepiness and dizziness are the most common side effects. Serious side effects include an increased risk of suicide, respiratory depression, and allergic reactions.[3] Lower doses are recommended in those with kidney disease.[3] Gabapentin acts by decreasing activity of a subset of calcium channels.[9][10][11] Gabapentin was first approved for use in 1993.[12] It has been available as a generic medication in the United States since 2004.[13] In 2019, it was the tenth most commonly prescribed medication in the United States, with more than 47 million prescriptions.[14][15] During the 1990s, Parke-Davis, a subsidiary of Pfizer, used a number of illegal techniques to encourage physicians in the United States to prescribe gabapentin for unapproved uses.[16] They have paid out millions of dollars to settle lawsuits regarding these activities.[17] Medical uses Gabapentin is recommended for use in focal seizures and neuropathic pain.[3][6] Gabapentin is widely prescribed off-label in the US and UK,[18][19] for example, for the treatment of non-neuropathic pain,[18] anxiety disorders and bipolar disorder.[20] Seizures Gabapentin is approved for the treatment of focal seizures;[21] however, it is not effective for generalized epilepsy.[22] Neuropathic pain Gabapentin is recommended as a first-line treatment for chronic neuropathic pain by various medical authorities.[6][7][23][24] This is a general recommendation applicable to all neuropathic pain syndromes except for trigeminal neuralgia.[7][24] In regard to the specific diagnoses, the best evidence exists for gabapentin treatment of postherpetic neuralgia and diabetic neuropathy.[8] Gabapentin is approved for the former indication in the US.[3] In addition to these two neuropathies, European Federation of Neurological Societies guideline notes gabapentin effectiveness for central pain.[7] A combination of gabapentin with an opioid or nortriptyline may work better than either drug alone.[7][24] Overall, gabapentin shows moderate effectiveness for neuropathic pain. Only a minority of patients obtain meaningful relief. Out of 10 persons treated with gabapentin, three to four benefit substantially as compared to one to two persons treated with placebo.[8] Evidence finds little or no benefit and significant risk in those with chronic low back pain or sciatica.[25][26] Gabapentin is not effective in HIV-associated sensory neuropathy[27] and neuropathic pain due to cancer.[28] Anxiety There is a small amount research on the use of gabapentin for the treatment of anxiety disorders.[29][30] In a controlled trial of breast cancer survivors with anxiety,[30] and in a trial for social phobia,[29] gabapentin significantly reduced anxiety levels. For panic disorder, gabapentin is ineffective.[30][29] Conversely, some psychiatric textbooks see "a possible role for gabapentin in anxiety disorders, particularly social phobia and panic disorder" based on "case reports and double-blind studies"[31] or state that controlled studies have not shown gabapentin to be very effective for psychiatric indications; "however, clinically it is effective".[20] Sleep Gabapentin is effective in treating sleep disorders such as insomnia and restless legs syndrome. Gabapentin enhances slow-wave sleep in patients with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal. The results suggest that gabapentin may be beneficial in the treatment of primary insomnia.[32] Drug dependence Gabapentin is moderately effective in reducing the symptoms of alcohol withdrawal and associated craving.[33][34][35] The evidence in favor of gabapentin is weak in the treatment of alcoholism: it does not contribute to the achievement of abstinence, and the data on the relapse of heavy drinking and percent of days abstinent do not robustly favor gabapentin; it only decreases the percent days of heavy drinking.[36] Gabapentin is ineffective in cocaine dependence and methamphetamine use,[37] and it does not increase the rate of smoking cessation.[38] Gabapentin does not significantly reduce the symptoms of opiate withdrawal.[37] There is insufficient evidence for its use in cannabis dependence.[39]

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Gabapentin: Usage, Side-effects, Dosage and More [gQgVE3BI2]

Gabapentin: Usage, Side-effects, Dosage and More [gQgVE3BI2]

. Chapters 0:00 Introduction 0:21 Uses of Gabapentin 1:26 Dosage for Gabapentin 2:51 Side effects of Gabapentin 3:39 Warnings Gabapentin, sold under the brand name Neurontin among others, is an anticonvulsant medication primarily used to treat partial seizures and neuropathic pain.[3][6] It is a first-line medication for the treatment of neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central pain.[7] It is moderately effective: about 30–40% of those given gabapentin for diabetic neuropathy or postherpetic neuralgia have a meaningful benefit.[8] Sleepiness and dizziness are the most common side effects. Serious side effects include an increased risk of suicide, respiratory depression, and allergic reactions.[3] Lower doses are recommended in those with kidney disease.[3] Gabapentin acts by decreasing activity of a subset of calcium channels.[9][10][11] Gabapentin was first approved for use in 1993.[12] It has been available as a generic medication in the United States since 2004.[13] In 2019, it was the tenth most commonly prescribed medication in the United States, with more than 47 million prescriptions.[14][15] During the 1990s, Parke-Davis, a subsidiary of Pfizer, used a number of illegal techniques to encourage physicians in the United States to prescribe gabapentin for unapproved uses.[16] They have paid out millions of dollars to settle lawsuits regarding these activities.[17] Medical uses Gabapentin is recommended for use in focal seizures and neuropathic pain.[3][6] Gabapentin is widely prescribed off-label in the US and UK,[18][19] for example, for the treatment of non-neuropathic pain,[18] anxiety disorders and bipolar disorder.[20] Seizures Gabapentin is approved for the treatment of focal seizures;[21] however, it is not effective for generalized epilepsy.[22] Neuropathic pain Gabapentin is recommended as a first-line treatment for chronic neuropathic pain by various medical authorities.[6][7][23][24] This is a general recommendation applicable to all neuropathic pain syndromes except for trigeminal neuralgia.[7][24] In regard to the specific diagnoses, the best evidence exists for gabapentin treatment of postherpetic neuralgia and diabetic neuropathy.[8] Gabapentin is approved for the former indication in the US.[3] In addition to these two neuropathies, European Federation of Neurological Societies guideline notes gabapentin effectiveness for central pain.[7] A combination of gabapentin with an opioid or nortriptyline may work better than either drug alone.[7][24] Overall, gabapentin shows moderate effectiveness for neuropathic pain. Only a minority of patients obtain meaningful relief. Out of 10 persons treated with gabapentin, three to four benefit substantially as compared to one to two persons treated with placebo.[8] Evidence finds little or no benefit and significant risk in those with chronic low back pain or sciatica.[25][26] Gabapentin is not effective in HIV-associated sensory neuropathy[27] and neuropathic pain due to cancer.[28] Anxiety There is a small amount research on the use of gabapentin for the treatment of anxiety disorders.[29][30] In a controlled trial of breast cancer survivors with anxiety,[30] and in a trial for social phobia,[29] gabapentin significantly reduced anxiety levels. For panic disorder, gabapentin is ineffective.[30][29] Conversely, some psychiatric textbooks see "a possible role for gabapentin in anxiety disorders, particularly social phobia and panic disorder" based on "case reports and double-blind studies"[31] or state that controlled studies have not shown gabapentin to be very effective for psychiatric indications; "however, clinically it is effective".[20] Sleep Gabapentin is effective in treating sleep disorders such as insomnia and restless legs syndrome. Gabapentin enhances slow-wave sleep in patients with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal. The results suggest that gabapentin may be beneficial in the treatment of primary insomnia.[32] Drug dependence Gabapentin is moderately effective in reducing the symptoms of alcohol withdrawal and associated craving.[33][34][35] The evidence in favor of gabapentin is weak in the treatment of alcoholism: it does not contribute to the achievement of abstinence, and the data on the relapse of heavy drinking and percent of days abstinent do not robustly favor gabapentin; it only decreases the percent days of heavy drinking.[36] Gabapentin is ineffective in cocaine dependence and methamphetamine use,[37] and it does not increase the rate of smoking cessation.[38] Gabapentin does not significantly reduce the symptoms of opiate withdrawal.[37] There is insufficient evidence for its use in cannabis dependence.[39]

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Aired: December 3rd 2024

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