Abstract

Background
Neuropathic pain is initiated or caused by a primary lesion or dysfunction in the nervous system. Current treatment modalities on neuropathic pain are often ineffective. Gabapentin, an anticonvul- sant, has become the first choice in the treatment of neuropathic pain. This study evaluated tolerability and efficacy of gabapentin therapy on neuropathic pain in routine clinical practice. Method: A multicenter, prospective, noncomparative, open label clinical trial was performed. 45 neu- rologists from 40 hospitals were participated in this study. A total of 1,202 adult patients(592 males, 610 females, mean age 59.0 years) with neuropathic pain entered the trial. Efficacy of gabapentin was evalua- ted in 1,017 patients after a minimum of 6 weeks of treatment. Results: Most patients were started on a dose of 300mg/day and mean maximum dosage was 874 mg/day. The average duration of treatment was 75.4 days. A total of 86 patients experienced 103 adverse events. The most frequent adverse events were dizziness(3.1%) and drowsiness(1.7%). Among 1,017 patients, physicians' clinical global improvement was 'markedly improved' in about 21% of patients, 'moderately improved' in about 40% and 'minimally improved' in about 26%. Mean daily pain score based on an 11-point Likert scale from baseline week to the final week of treatment was significantly reduced from 6.1 to 3.2(p<0.0001). Sleep interference score was also significantly reduced from 3.3 to 1.7(p<0.0001). Conclusions: The results of this study, performed in a real situation of clinical practice, confirmed safety and effectiveness of gabapentin in the treatment of neuropathic pain. Korean Journal of Headache 5(2):129-138, 2004