Gabapentin for chronic neuropathic pain and fibromyalgia in adults

Antiepileptic drugs like gabapentin are commonly used for treating neuropathic pain, usually defined as pain due to damage to nerves. This would include postherpetic neuralgia (persistent pain experienced in an area previously affected by shingles), painful complications of diabetes, nerve injury pain, phantom limb pain, fibromyalgia and trigeminal neuralgia. This type of pain can be severe and long-lasting, is associated with lack of sleep, fatigue, and depression, and a reduced quality of life. In people with these conditions, gabapentin is associated with a moderate benefit (equivalent to at least 30% pain relief) in almost one in two patients (43%), and a substantial benefit (equivalent to at least 50% pain relief) in almost one in three (31%). Over half of those taking gabapentin for neuropathic pain will not have good pain relief, in common with most chronic pain conditions. Adverse events are experienced by about two-thirds of people taking gabapentin, mainly dizziness, somnolence (sleepiness), oedema (swelling), and gait disturbance, but only about 1 in 10 (11%) have to stop the treatment because of these unpleasant side effects. Overall gabapentin provides pain relief of a high level in about a third of people who take it for painful neuropathic pain. Adverse events are frequent, but mostly tolerable. This review looked at evidence from 29 studies involving 3571 participants.