Effect Of Gabapentin Research Articles

Gabapentin reduces stress and does not affect ocular parameters in clinically normal cats.

To describe the effects of gabapentin on ocular and behavioral parameters following oral administration in healthy cats. Masked, placebo-controlled, randomized crossover-design study. Ten young, healthy cats were scheduled for two veterinary visits 7 days apart and randomly assigned to receive a compounded capsule containing 100 mg of gabapentin or placebo (100 mg lactose powder) at the first visit and the opposite treatment at the second visit. Respiratory rate, heart rate, stress score, sedation score, compliance score, horizontal pupil diameter, intraocular pressure, and Schirmer tear test-1 were measured prior to and 1.5, 3, and 6h following capsule administration. Stress score, sedation score, and compliance score were assigned based on established behavioral scales. Results of the two treatments were statistically compared with a p-value <0.05 considered significant. Respiratory rate was significantly reduced at 1.5 (p=0.049) and 3 (p=0.03) hours following gabapentin administration. Stress score was significantly reduced at 1.5 (p=0.01) hours following gabapentin administration. Sedation score was significantly increased at 1.5 (p=0.015) and 3 (p=0.03) hours following gabapentin administration. Gabapentin had no significant effect on heart rate, compliance score, or ocular values measured in this study. Gabapentin reduces stress and increases sedation at 1.5h after treatment, with no significant effect on horizontal pupil diameter, intraocular pressure or Schirmer tear test-1 results.

Gabapentin inhibits the analgesic effects and nerve regeneration process induced by hepatocyte growth factor (HGF) in a peripheral nerve injury model: Implication for the use of VM202 and gabapentinoids for peripheral neuropathy

Hepatocyte growth factor (HGF) is a multifunctional protein that plays a critical role in the angiogenic, neurotrophic, antifibrotic, and antiapoptotic activities of various cell types. It has been previously reported that intramuscular injection of pCK-HGF-X7 (or VM202), a plasmid DNA designed to express both native isoforms of human HGF (Pyun et al., 2010), significantly reduced the level of neuropathic pain in clinical studies as well as in a variety of animal models. In clinical studies, it has been observed that pCK-HGF-X7 appeared to give much higher pain-relieving effects in subjects not taking pregabalin or gabapentin, α2δ1 calcium channel blockers frequently prescribed for reducing pain in patients with diabetic peripheral neuropathy. In this study, we tested the effects of gabapentin on HGF-mediated pain reduction and nerve regeneration in vivo. Consistent with the data from clinical studies, gabapentin administration inhibited the pain reduction and axon regeneration effects mediated by HGF expression from pCK-HGF-X7. In the context of nerve regenerative effects, treatment with gabapentin or EGTA, a Ca2+ chelator, inhibited HGF-mediated axon outgrowth of injured sciatic nerves in vivo. Taken together, i.m. injection of HGF-encoding plasmid DNA ameliorated pain symptoms and enhanced the regeneration of injured nerves, and these therapeutic effects of HGF were significantly hindered by gabapentin treatment, suggesting the possible involvement of Ca2+ in the pro-regenerative activities of native HGF derived from treatment with pCK-HGF-X7.

Influence of methadone on the anticonvulsant efficacy of valproate sodium gabapentin against maximal electroshock seizure in mice by regulation of brain MDA TNF-α.

Methadone is the most frequently used opioid therapy worldwide, with controversial effects on oxidative stress homeostasis. This study investigated the effects of intraperitoneal (i.p.) co-administration of methadone (0.1, 0.3, 1, and 3 mg/kg) and valproate sodium (300 mg/kg) or gabapentin (50 mg/kg) in the mice maximal electroshock (MES)-induced seizure model. The adverse effect of drugs was assessed using the chimney test. The levels of tumor necrosis factor-alpha (TNF-α) and malondialdehyde (MDA) contents were measured in mice brains after a single seizure. Administration of methadone alone resulted in a significant reduction in the duration of hind limb extension (HLE) than that in the control group. Methadone pretreatment at doses of 0.1 and 0.3 mg/kg i.p. decreased, and at doses of 1 and 3 mg/kg i.p. had an increasing effect on anticonvulsant efficacy of gabapentin. Pretreatment with all doses of methadone significantly decreased the valproate anticonvulsive efficacy. At doses of 1 and 3 mg/kg i.p. methadone per se increased brain MDA levels after MES-induced seizure. Administration of methadone (0.3 mg/kg i.p.) enhanced and at 3 mg/kg decreased gabapentin effect on brain MDA level, but their co-treatment did not lead to further increase in MDA. Methadone at 0.3–3 mg/kg enhanced the effect of sodium valproate on MDA levels in the brain, but at all doses significantly potentiated its effect on brain TNF-α levels. The drugs did not produce any side effects on motor coordination in experimental animals. In conclusion, methadone showed different effects on anticonvulsant actions of gabapentin and valproate through regulation of brain levels of MDA and TNF-α.

Topical gabapentin 10% in the treatment of epidermolysis bullosa pruritus: A pilot, double-blind, split-site, randomized controlled trial.

Pruritus is a symptom that adversely affects the quality of life of patients with epidermolysis bullosa (EB). Although studies indicate the positive effect of gabapentin on some types of pruritus, its effect on pruritus due to EB remains unexplored. Hence, this study investigated the efficacy of topical gabapentin in treating EB pruritus. We piloted a 6-week, double-blind, split-site, randomized controlled trial on 14 patients with EB pruritus. In each patient, one pruritic lesion received topical gabapentin and the other a placebo. The items of the Leuven Itch Scale were evaluated before and after therapy; the lesions were photographed, and their appearance (i.e., erythema and excoriation severity, pruritic geometric area) was objectively assessed. Statistical analyses were made using SPSS v. 25. Quantitative data were reported as median (interquartile range) or mean ± standard deviation as appropriate. The median age of the 14 patients was 18 years (12-37), and the majority (64.3%) were male. A significant improvement was seen in the geometric area of the pruritic lesion in the intervention group (p= 0.005) but not in the control group (p= 0.054). Erythema severity, excoriation intensity, pruritus frequency and duration, and symptom-related distress significantly improved in both groups (p< 0.05 in all cases), but topical gabapentin failed to offer any statistical superiority relative to the placebo in the between-group analysis (p> 0.05). This study showed no significant difference between topical gabapentin and placebo in erythema severity, excoriation intensity, pruritus frequency and duration, and symptom-related distress among EB patients. However, the lesion area decreased only in the gabapentin group.

Comparing the therapeutic effects of pregabalin and gabapentin after transforaminal epidural nerve block in lumbar radiculopathy.

Lumbar radiculopathy can be presented as low back pain and radiating pain. Transforaminal epidural steroid injection (TFESI) has been used to treat radicular pain, and after the injection, additional medications such as gabapentinoids including pregabalin (PGB) and gabapentin (GBP) can be administered to relieve remnant pain. However, little is known about the effectiveness of gabapentinoids in relieving pain after transforaminal epidural steroid injection.This study was conducted to compare the effect of pregabalin and gabapentin in lumbar radiculopathy patients who underwent transforaminal epidural steroid injection.One hundred seven patients who received TFESI and had taken PGB or GBP after the intervention at Daegu Catholic University Medical Center from January 2013 to August 2021 were included in this study. Visual Analogue Scale (VAS) was evaluated in all patients.Among 107 patients, 57 (53.3%) patients took PGB and 50 (46.7%) patients took GBP after TFESI. The PGB and GBP groups showed reduced VAS scores according to visit (P < .001). However, no statistically significant differences in VAS scores according to the types of medication (P = .811) and change aspects according to visit were observed between the PGB and GBP groups (P = .947).The study findings suggest that both pregabalin and gabapentin can be equally used to reduce pain in lumbar radiculopathy patients who underwent TFESI. Further studies with larger sample size are needed to generalize the findings of this study.

The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure-A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial.

The aim of the study was to investigate whether the use of pre- and postoperative gabapentin can decrease postoperative pain, morphine consumption, anxiety and side effects, as well as improve patient satisfaction. A total of 56 patients, 9–17 years of age, undergoing a modified Ravitch procedure, were randomised (allocation ratio 1:1) to receive multiple perioperative doses of gabapentin (preoperatively 15 mg/kg, postoperatively 7.5 mg/kg, two times per day for three days) or a placebo. All the patients received intravenous infusion of morphine, paracetamol and non-steroidal anti-inflammatory drugs. Metamizole was given as a “rescue drug”. The observation period included the day of surgery and three postoperative days. The primary outcomes were postoperative pain intensity (at rest, during deep breathing and coughing). Additional outcomes included the consumption of morphine, the total number of doses of metamizole, anxiety, postoperative side effects and patient satisfaction. Median average and maximal pain scores (on the day of surgery and on the second postoperative day) were significantly lower only in the gabapentin group at rest (p < 0.05). Compared to the placebo group, gabapentin treatment reduced the demand for morphine on the first postoperative day (median 0.016 vs. 0.019 mg/kg/h; p = 0.03) and the total number of metamizole doses (median 1 vs. 2 p = 0.04). Patient satisfaction was significantly greater in the gabapentin group (median 10 vs. 9; p = 0.018). Anxiety and postoperative side effects were similar in both groups (p > 0.05). Pre- and postoperative gabapentin administration as part of a multimodal analgesic regimen may decrease postoperative pain, opioid consumption and demand for a “rescue drug”, as well as improve patient satisfaction.

Effects of gabapentin and trazodone on electroretinographic responses in clinically normal dogs.

To compare electroretinographic (ERG) responses obtained in dogs before and after oral administration of gabapentin, trazodone, and a combination of both medications. 12 clinically normal dogs. A short-protocol ERG with 20 minutes of dark adaption was recorded for all dogs to establish baseline ERG responses. Dogs then received gabapentin (approx 30 mg/kg), trazadone (approx 20 mg/kg or approx 5 mg/kg), or a combination of gabapentin (approx 20 mg/kg) and trazodone (approx 5 mg/kg) orally, and the same ERG protocol was repeated 2 hours later. Dogs were given a washout period of at least 1 week between treatments. a-Wave amplitudes were significantly (P = 0.018) decreased after administration of the combination of gabapentin and trazodone. b-Wave amplitudes were significantly decreased after administration of the 20-mg/kg dose of trazodone (P = 0.006) and after administration of the combination of gabapentin and trazodone (P = 0.002). Heavier dogs that received higher total doses of trazodone had decreases in a-wave amplitude after administration of the 20-mg/kg dose of trazodone and in b-wave amplitude after administration of the 5-mg/kg dose of trazodone. High doses of trazodone and the combination of gabapentin and trazodone significantly decreased a-wave and b-wave amplitudes in clinically normal dogs. However, the effects on retinal responses had little clinical importance. Therefore, these medications can be used safely in a clinical setting; however, further studies are needed in dogs with retinal disease.

Sleep and behavioral disturbances induced by epilepsy: Protective effect of Gabapentin

Numerous sleep disturbances induced by nocturnal epilepsy have been reported. Gabapentin (GBP) is used as an adjuvant or as a monotherapeutic treatment as it induces significant improvement in patients with partial or secondaryly widespread focal seizures. In experimental animal models of epilepsy with pentilenetetrazole (PTZ), GBP protects against the generated seizures. The objective of this work was to investigate its effectiveness in protecting against motor and sleep disturbances caused by seizures. Polygraphic studies were conducted in male wistar rats, separated into 4 groups. After administration of saline solution, a check record was carried out on each group. Subsequently, one group received 50 mg/kg of PTZ, while the other three groups received 15, 30 or 60 mg/kg GBP, 30 minutes prior to PTZ administration. After administration of PTZ, electrophysiological and behavioral manifestations characterizing seizures were observed. In addition, surveillance states were significantly altered, increasing the amount of wakefulness, while sleep was inhibited over a period of time. The administration of increasing doses of GBP tended to inhibit the presence of abnormal motor behaviors, facilitating the presence of sleep.

The effectiveness of gabapentin and gabapentin/montelukast combination compared with dextromethorphan in the improvement of COVID-19- related cough: A randomized, controlled clinical trial.

IntroductionCough is one of the most common presenting symptoms of COVID‐19, which can persist for weeks or months.ObjectiveThe goal of this study was to evaluate the effectiveness of gabapentin (GBT) alone and in combination with montelukast (MTL) for improving cough.MethodsIn this open‐label randomized controlled clinical trial, eligible cases were patients hospitalized with moderate to severe COVID‐19 who had cough with a Breathlessness, Cough, and Sputum Scale (BCSS) score of at least 2 based on its cough subscale. The participants were randomly assigned to three groups including two experimental groups and one control group. The first and second experimental groups received GBT and GBT/MTL, respectively, whereas the control group received dextromethorphan (DXM). Treatment duration was 5 days in all groups. Before and after the interventions, the severity of cough was evaluated using BCSS scale and Visual Analog Scale (VAS).ResultsA total of 180 patients were included; GPT, GPT/MTL, and DXM consisted of 76, 51, and 53 patients, respectively. There was no significant difference between the three groups in terms of age, gender, and comorbidities (P > 0.05). Regarding BCSS and VAS scores, there was significant reduction from the baseline values in all groups (P < 0.0001), with the change rate being significantly higher in DXM group. The amount of reduction of BCSS in the GPT/MTL group was significantly more than the GPT group, whereas there was no significant difference between the two groups regarding VAS score. Although the duration of hospitalization differed between the groups with the GPT/MTL group having the shortest duration, the difference was statistically significant only between the GPT and GPT/MTL groups (P < 0.0001).ConclusionGPT, both alone and in combination with MTL, improves cough frequency and severity in hospitalized patients with COVID‐19, with the combination being more efficacious. This regimen may be useful in patients who cannot tolerate opioids.

Effect of gabapentin on neurogenesis in hippocampal dentate gyrus of adult rats with co-disease of chronic pain and depression.

Chronic pain lasts for more than 3 months and is often associated with negative emotions such as depression and anxiety. Long-term chronic pain stress can lead to plastic changes in hippocampal structure and function. In addition to its analgesic effect, gabapentin also has certain cerebral protective effects. This study aims to observe the effect of gabapentin on neurogenesis in hippocampal dentate gyrus (DG) of the adult rats with co-disease of chronic pain and depression. The adult rats were randomly divided into 4 groups: A sham operation (Sham) group, a comorbidity model+normal saline (CCI+Veh) group (1 mL saline), a comorbidity model+low-dose gabapentin (CCI+LG) group (diluting gabapentin with normal saline to 1 mL at the dose of 30 mg/kg), and a comorbidity model+high-dose gabapentin (CCI+HG) group (diluting gabapentin with normal saline to 1 mL at the dose of 100 mg/kg) (8 rats per group). The comorbidity model was established by sciatic nerve encirclement. On the 30th day after operation, normal saline, low-dose gabapentin, and high-dose gabapentin were given intraperitoneally, respetively, for 7 consecutive days. The paw withdrawal mechanical threshold (PWMT) of the right hindlimb was measured before the operation and on the 7th, 14th, 21th, 28th, and 40th day after the operation. The time of immobility and sugar water preference rate were measured by forced swimming test and sugar water preference test, respectively, on the 28th and 40th day after the operation. The number of doublecortin (DCX) positive neurons and the expression of brain-derived neurotrophic factor (BDNF) in hippocampal dentate gyrus were observed by immunohistochemical staining, and the morphological changes of the hippocampal neurons were observed by Golgi staining. Compared with the Sham group, the PWMT of the CCI comorbidity model rats reached the lowest level on the 7th day after the operation and lasted until the 28th day after the operation, and remained at a low level on the 40th day after the operation (all P<0.05). Compared with the CCI+Veh group, the PWMT in the CCI+LG group and the CCI+HG group was increased on the 40th day after the operation (all P<0.05). Compared with the Sham group, the time of immobility in the CCI comorbidity model rats was increased significantly (all P<0.01) and the sugar water preference rate was decreased significantly (all P<0.01) on the 28th day after the operation. Compared with the CCI+Veh group, the time of immobility in the CCI+HG group was shortened (P<0.05) and the sugar water preference rate was significantly increased (P<0.01) on the 40th day after the operation. Compared with the CCI+Veh group, the number of DCX positive cells in hippocampal DG of the CCI+LG group and the CCI+HG group was increased, and that in the CCI+HG group was increased more significantly (P<0.05). Compared with the Sham group, the expression of BDNF in hippocampal DG was decreased in the CCI+Veh group (P<0.05). Compared with the CCI+Veh group, the expression of BDNF in hippocampal DG and the length of dendritic spines of the hippocampal neurons were increased in the CCI+HG group (all P<0.05). Gabapentin can relieve chronic pain and depression-like behavior in rats with chronic pain and depression, and promote neurogenesis of hippocampal dentate gyrus neurons.

Prenatal Exposure to Gabapentin Alters the Development of Ventral Midbrain Dopaminergic Neurons.

Background: Gabapentin is widely prescribed as an off-label drug for the treatment of various diseases, including drug and alcohol addiction. Approximately 83–95% of the usage of gabapentin is off-label, accounting for more than 90% of its sales in the market, which indicates an alarming situation of drug abuse. Such misuse of gabapentin has serious negative consequences. The safety of the use of gabapentin in pregnant women has always been a serious issue, as gabapentin can cross placental barriers. The impact of gabapentin on brain development in the fetus is not sufficiently investigated, which poses difficulties in clinical decisions regarding prescriptions. Methods: The consequences effect of prenatal gabapentin exposure on the development of ventral midbrain dopaminergic neurons were investigated using three-dimensional neuronal cell cultures. Time-mated Swiss mice were used to isolate embryos. The ventral third of the midbrain was removed and used to enrich the dopaminergic population in 3D cell cultures that were subsequently exposed to gabapentin. The effects of gabapentin on the viability, ATP release, morphogenesis and genes expression of ventral midbrain dopaminergic neurons were investigated. Results: Gabapentin treatment at the therapeutic level interfered with the neurogenesis and morphogenesis of vmDA neurons in the fetal brain by causing changes in morphology and alterations in the expression of key developmental genes, such as Nurr1, Chl1, En1, Bdnf, Drd2, and Pitx3. The TH + total neurite length and dominant neurite length were significantly altered. We also found that gabapentin could halt the metabolic state of these neuronal cells by blocking the generation of ATP. Conclusion: Our findings clearly indicate that gabapentin hampers the morphogenesis and development of dopaminergic neurons. This implies that the use of gabapentin could lead to serious complications in child-bearing women. Therefore, caution must be exercised in clinical decisions regarding the prescription of gabapentin in pregnant women.

Gabapentinoids Suppress Lipopolysaccharide-Induced Interleukin-6 Production in Primary Cell Cultures of the Rat Spinal Dorsal Horn

Introduction: Gabapentin and pregabalin are drugs to treat neuropathic pain. Several studies highlighted effects on presynaptic terminals of nociceptors. Via binding to α₂δ subunits of voltage-gated calcium channels, gabapentinoids modulate the synaptic transmission of nociceptive information. However, recent studies revealed further properties of these substances. Treatment with gabapentin or pregabalin in animal models of neuropathic pain resulted not only in reduced symptoms of hyperalgesia but also in an attenuated activation of glial cells and decreased production of pro-inflammatory mediators in the spinal dorsal horn. Methods: In the present study, we aimed to investigate the impact of gabapentinoids on the inflammatory response of spinal dorsal horn cells, applying the established model of neuro-glial primary cell cultures of the superficial dorsal horn (SDH). We studied effects of gabapentin and pregabalin on lipopolysaccharide (LPS)-induced cytokine release (bioassays), expression of inflammatory marker genes (RT-qPCR), activation of transcription factors (immunocytochemistry), and Ca²⁺ responses of SDH neurons to stimulation with substance P and glutamate (Ca²⁺-imaging). Results: We detected an attenuated LPS-induced expression and release of interleukin-6 by SDH cultures in the presence of gabapentinoids. In addition, a significant main effect of drug treatment was observed for mRNA expression of microsomal prostaglandin E synthase 1 and the inhibitor of nuclear factor kappa B. Nuclear translocation of inflammatory transcription factors in glial cells was not significantly affected by gabapentinoid treatment. Moreover, both substances did not modulate neuronal responses upon stimulation with substance P or glutamate. Conclusion: Our results provide evidence for anti-inflammatory capacities of gabapentinoids on the acute inflammatory response of SDH primary cultures upon LPS stimulation. Such effects may contribute to the pain-relieving effects of gabapentinoids.

Postoperative Gabapentin's Effect on Opioid Consumption and Pain Control Following Sinonasal Surgery.

This study investigates the impact of postoperative gabapentin on opioid consumption and pain control following endoscopic sinus surgery (ESS) and/or septoplasty. Patients who underwent ESS and/or septoplasty at a single institution from 2021 to 2022 were enrolled. All patients received postoperative hydrocodone-acetaminophen for pain control. Half of the patients were also prescribed gabapentin for the first postoperative day in addition to hydrocodone-acetaminophen. Subjects completed the Revised American Pain Society Patient Outcome Questionnaire 24 h and 7 days after surgery. We conducted a multivariable regression analysis to assess opioid consumption and improvement in pain scores in the first week between gabapentin and non-gabapentin groups. A total of 102 subjects, 51 in each arm, were enrolled. The mean age was 52 years and 53% of participants were female. Controlling for important baseline demographic, clinical, and surgically related variables, the addition of postoperative gabapentin was associated with a 44% (9.5 mg from 21.6 mg) reduction in opioids consumed in the first postoperative week (B=-9.54, 95% C.I.=[-17.84, -1.24], p=0.025). In addition, patients in both arms exhibited similar improvement in pain severity and sleep interference in the first 7 days (B=-1.59, 95% C.I.=[-5.03, 1.84], p=0.36). To the best of our knowledge, this is the first study to investigate the impact of postoperative gabapentin on opioid consumption and pain control following ESS and/or septoplasty. Our analysis demonstrated that postoperative gabapentin effectively reduced opioid use during the first postoperative week without compromising pain control. 3 Laryngoscope, 133:1065-1072, 2023.

Gabapentin Alleviates Brain Injury in Intracerebral Hemorrhage Through Suppressing Neuroinflammation and Apoptosis.

Neuroinflammation plays an important role in brain tissue injury during intracerebral hemorrhage. Gabapentin can reduce inflammation and oxidative stress through inhibiting nuclear factor κB (NFκB) signals. Here, we showed that gabapentin reduced brain tissue injury in ICH through suppressing NFκB-mediated neuroinflammation. ICH was induced by injecting collagenase IV into the right striatum of Sprague-Dawley rats. PC12 and BV2 cells injury induced by Hemin were used to simulate ICH in vitro. Inflammation and apoptosis were assessed in rat brain tissue and in vitro cells. The neurobehavioral scores were significantly decreased in ICH rats compared with sham rats. Phosphorylated IκB-α and cleaved caspase3, and apoptosis rate were significantly higher in tissue surrounding the hematoma than in brain tissues from rats subjected to sham surgery. Furthermore, serum IL-6 levels in ICH rats were higher than in sham rats. Gabapentin treatment significantly improved the behavioral scores, decreased levels of phosphorylated IκB-α and cleaved caspase3, apoptosis rate, and serum IL-6 level in ICH rats. Hemin-treated BV2 cells displayed higher levels of phosphorylated IκB-α, cleaved caspase3, and IL-6 in the supernatant compared with vehicle-treated cells. Hemin treatment induced a significantly lower level of peroxisome proliferator-activated receptor γ (PPARγ) in BV2 cells. BV2-PC12 co-culture cells treated by hemin displayed higher levels of cleaved caspase3 in PC12 cells. Furthermore, gabapentin treatment could reduce these effects induced by hemin and the protective effects of gabapentin were significantly attenuated by PPARγ inhibitor. Therefore, gabapentin may reduce inflammation and apoptosis induced by the ICH through PPARγ-NFκB pathway.

A Comparative Study to Analyze the Effect of Gabapentin with Amitriptyline Versus Pregabalin with Amitriptyline in Neuropathic Pain in Cancer Patients Undergoing Palliative Care

Introduction: Antiepileptics and antidepressant medications are known for managing neuropathic pain. We aim to compare the effects of pregabalin with low-dose amitriptyline and gabapentin with low-dose amitriptyline in managing neuropathic pain in cancer patients undergoing palliative care. Materials and Methods: We conducted our study on 160 cancer patients who were having neuropathic pain and were undergoing palliative care treatment in our institute. It was a hospital-based, randomized, tertiary cancer center-based observational study. After taking approval from the institutional ethics committee and taking written informed consent from patients, the patients were divided into two groups and the effect of medicines on incidence of neuropathic pain was observed; the incidence of burning sensation and the incidence of adverse effects of medications were also analyzed. Statistical analysis was done using paired t-test and SPSS version 20 software. Results: The onset of relief in pain was earlier in the pregabalin group as compared to the gabapentin group. There was more reduction in a burning sensation in the pregabalin group as compared to the gabapentin group. The incidence of headaches was the same in both groups. Nausea and vomiting were more in the pregabalin group but the overall difference in adverse effects was not statistically significant (P &gt; 0.05) Conclusions: In the management of neuropathic pain in cancer patients who are undergoing palliative care, a combination of pregabalin with amitriptyline was found to be more effective in pain relief than gabapentin with amitriptyline.

Comparison of effect of preemptive use of oral gabapentin and pregabalin for acute postoperative pain after Partial Thyroidectomy

Background and Aims: Preemptive analgesia is defined as a treatment that is initiated before surgery in order to prevent the establishment of central sensitization evoked by the incisional and inflammatory injuries occurring during surgery and postoperative period. Pregabalinas considered in abolishing neuropathie component of acute nociceptive pain of surgery. Materials and methods: A study was done to know the effect of oral gabapentin and pregabalinath control group for post-operative analgesia. Materials and Methods: A total of 90 ASA grade I and II patients posted for elective Partial thyroidectomy were randomized into 3 groups (group A, B and C of 30 patients each). One hour before surgery the blinded drug selected for the study was given with a sip of water. Group C- received identical placebo tablet, Group B- received 800 mg of gabapentin tablet and Group A - received 150 mg of pregabalinablet . VAS score recorded for initial rescue analgesia, total duration of analgesia and total requirement of rescue analgesia were observed as primary outcome. Hemodynamics andside effects were recorded as secondary outcome in patients. Results: The analgesic requirement in both Pregabalinand Gabapentin groups are lower than the control group.

The investigation of possible beneficial effects of gabapentin on adverse cardiac effects of high dose zoledronic acid: an experimental study

The investigation of possible beneficial effects of gabapentin on adverse cardiac effects of high dose zoledronic acid: an experimental study

Gabapentinoids Attenuate Naloxone Reversal of Heroin‐Induced Ventilatory Depression

A growing body of epidemiological evidence suggests increasing misuse of gabapentinoids (gabapentin and pregabalin, calcium channel inhibitors approved to treat some neuropathic pain conditions) in people with opioid use disorder. The number of prescriptions for gabapentinoids has risen rapidly over the past decade, with the majority of these prescriptions being for off‐label indications. Over the same period, gabapentinoids have become increasingly prevalent in opioid overdose deaths. Despite these trends little research has evaluated potentially harmful interactions between gabapentinoids and opioids. This study evaluated the effects of gabapentin and pregabalin on the ventilatory depressant effects of heroin, and the reversal of heroin‐induced ventilatory depression by naloxone. Five male Sprague Dawley rats were given pregabalin (1‐32 mg/kg), gabapentin (10‐100 mg/kg), or saline i.v. 30 minutes prior to receiving increasing doses of heroin while ventilation was monitored using whole‐body plethysmography. Sessions began with a 30‐minute baseline period followed by a test period during which rats received infusions of heroin or saline at minutes 0, 3, and 6 with heroin infusions resulting in cumulative doses of 0.1, 0.32, and 1 mg/kg (i.v.), respectively. Naloxone (0.0056‐0.01 mg/kg) or saline was administered i.v. 5 minutes following the final infusion of heroin. Minute volume, the product of tidal volume (mL/inspiration) and respiratory rate (breaths/minute), was the primary outcome of this study. Heroin dose‐dependently reduced minute volume with 1.0 mg/kg reducing minute ventilation on average to 42% of baseline. Neither pregabalin nor gabapentin altered the ventilatory depressant effects of heroin. When given 5 minutes following the 1.0 mg/kg cumulative dose of heroin, naloxone dose‐dependently reversed heroin‐induced decreases in minute volume with 0.0056 and 0.01 mg/kg naloxone restoring ventilation to 95 and 160% of baseline levels, respectively. Interestingly, pretreatment with gabapentin or pregabalin dose‐dependently attenuated the ability of naloxone to reverse heroin‐suppressed minute volume, with the largest dose of gabapentin and pregabalin almost completely blocking the effects of 0.0056 mg/kg naloxone. Both gabapentin and pregabalin attenuated the ability of naloxone to restore ventilation following administration of heroin in rats but did not alter the effects of heroin alone. These findings suggest that gabapentinoids might diminish the effectiveness of naloxone to reverse opioid overdose in humans, a possible explanation for the prevalence of these drugs in opioid overdose deaths. It will be important to determine whether similar interactions occur between gabapentinoids and naloxone for reversing the effects of other mu opioid receptor agonists such as fentanyl.

Comparative study of gabapentin versus pregabalin as a premedication in patients undergoing FESS under general anaesthesia

Introduction: Functional endoscopic sinus surgery (FESS) is a minimally invasive procedure which is usually done under general anaesthesia. Laryngoscopy and tracheal intubation may induce an intense sympathetic hemodynamic response which is dangerous in patients with comorbidities. So an effective and safe premedication drug to attenuate this response is very much necessary. Objectives: The present study was designed to compare the effects of oral gabapentin and oral pregabalin as a premedication to produce sedation and attenuate haemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing FESS under general anaesthesia. Methods: This prospective, randomized study was undertaken in ENT operation theatre in a Government teaching hospital, Karnataka between July 2020 and June 2021. Group A received gabapentin 600 mg and Group B received pregabalin 150 mg orally one hour prior to induction of general anaesthesia. Results: Patients in both group A and group B were sedated after premedication but the degree of sedation achieved in group B was higher compared to group A (p &lt;0.05). Attenuation of HR and MAP was also higher in group B compared to group A (p &lt;0.05). Conclusion: Premedication with both oral pregabalin 150mg and oral gabapentin 600mg, given 1 hour before general anaesthesia in patients undergoing FESS produce sedation and attenuate hemodynamic response to laryngoscopy and intubation. But premedication with oral pregabalin 150 mg is more effective than oral gabapentin 600 mg in producing sedation and attenuating the hemodynamic responses to laryngoscopy and intubation. Keywords: gabapentin; pregabalin; FESS; anaesthesia

Effectiveness of gabapentin in reducing opioid requirements after radiation in head and neck cancer in a single institution.

Gabapentin has been shown to reduce opioid use in head and neck cancer patients. Here, we examine the efficacy of prophylactic gabapentin at reducing opioid use in these patients at our institution. A retrospective study of patients receiving radiation was performed, using patients from our previous study as controls. Risk factors for opioid use at 3 and 6 months were determined using univariate and multivariate analyses. In total, 53/185 patients were treated with gabapentin, 39.6% of which took opioids at 3months vs. 58.3% in the non-gabapentin cohort (p=0.021). Gabapentin was independently associated with less opioid use on multivariate analysis at 3months (OR 0.47, 95% CI 0.24-0.9). Gastrostomy tube dependence and pretreatment opioid use were associated with chronic opioid use despite gabapentin. Gabapentin is effective at expediting opioid tapering in head and neck cancer patients who are not gastrostomy tube dependent or taking opioids pretreatment.