Gabapentin In Patients Research Articles

Pain Control and Opioid Consumption in Patients Undergoing Total Hip or Knee Arthroplasty Receiving a Preoperative Low Dose of Gabapentin

Background: Meta-analyses and randomized controlled trials were inconclusive regarding the role of gabapentinoids in patients undergoing joint arthroplasties. The aim of the present study was to investigate the effect of a preoperative low dose of gabapentin in patients undergoing total hip (THA) and knee arthroplasties (TKA). Methods: A retrospective observational study was conducted on 135 patients undergoing THA and TKA at the National Orthopedic Hospital Cappagh, Dublin, from July to December 2022. The primary outcome was the assessment of numerical rating scores (NRS) for postoperative pain at various time intervals. Results: During the observation period, 55 patients received a preoperative dose of gabapentin, while 80 patients did not. Statistically significant differences in numerical rating scores (NRS) were found at 6 (3 vs. 0, p < 0.001), 12 (4 vs. 2, p < 0.001), 18 (4 vs. 3, p < 0.001), and 24 h (4 vs. 3, p = 0.010) after surgery, in favor of the group receiving gabapentin. A reduction in opioid consumption, measured as morphine equivalents, was also noted in the gabapentin group (40 vs. 30 mg, p = 0.040). Conclusions: A low preoperative dose of gabapentin was associated with reduced postoperative pain and opioid consumption in patients undergoing TKA and THA, without impacting hospital stay. Prospectively designed trials are encouraged to assess the safety and effect on pain control of a preoperative low dose of gabapentin.

Comparing the effectiveness of pregabalin and gabapentin in patients with lumbar radiculopathy: A systematic review and meta-analysis.

Gabapentinoids are commonly prescribed to control neuropathic pain of lumbar radiculopathy. Few trials have compared the efficacy of gabapentin (GBP) and pregabalin (PGB). Therefore, the authors conducted a meta-analysis to compare the difference in effect between GBP and PGB in lumbar radiculopathy patients. Articles which were published between January 1, 1960 and May 31, 2023 were investigated via Cochrane Central Register of Controlled Trials, Embase, Google Scholar, and MEDLINE. This meta-analysis was conducted on patients with lumbar radiculopathy. Gabapentin was used as an intervention, and pregabalin as a comparison. As outcomes, pain rating scales including visual analog scale (VAS) and numeric pain rating scale (NRS), and number of adverse events (dizziness and sedation) were obtained. PGB showed statistically significant improvement in pain scale (VAS and NRS) in short-term follow-up (6 weeks or less) compared to GBP. (Total mean difference of -0.31) However, in the long-term follow-up (6 weeks to 12 weeks), there was no difference in pain reduction effect between two groups. The incidence of AEs showed no difference between two groups. Based on this article, the existing evidence suggests that PGB was more effective in reducing pain of lumbar radiculopathy compared to GBP at the short-term follow-up, but there was no difference in the long-term follow-up. Physicians should consider this finding in prescribing medications for patients with lumbar radiculopathy.

Preoperative Gabapentin for Pain Control: A Randomized, Placebo-controlled Clinical Trial in Patients Undergoing Inguinal Hernioplasty

PurposeThe perioperative use of gabapentin has been suggested to reduce postoperative pain and opioid consumption. However, there is a variation in clinical practice, the type of surgery and the administration time seem to be distinct between the available studies. We assess whether gabapentin administered before surgery reduces postoperative pain in patients who have undergone inguinal hernioplasty. DesignThis is a double-blind, randomized, and placebo-controlled trial. MethodsSeventy-seven patients scheduled for inguinal hernioplasty were randomized in two groups to receive gabapentin (900 mg) or placebo in the perioperative period. The primary outcome was analgesia measured by visual analog scale up to 30 days after surgery. The secondary outcomes such as morphine consumption, nausea, headache, and sedation have been also described. FindingsPatients who received gabapentin had lower postoperative pain scores compared to the control group, P < .001. The postoperative morphine use was significantly lower in the gabapentin (5.3%) versus placebo group (74.4%), P < .001. No significant difference between groups was observed for the occurrence of adverse events. ConclusionsThe perioperative administration of gabapentin was effective in reducing postoperative pain and had an important effect in decreasing morphine use. Together, our data reveal a long-lasting opioid-sparing effect of gabapentin in patients who underwent inguinal hernioplasty.

The use of low doses of gabapentin in patients with neuropathic pain and with thrombocytopenia

Introduction. Approximately 21–27% of patients with blood system diseases receive opioid analgesics, with neuropathic pain being one of the most common reasons for prescription. Gabapentin is used as a first-line drug for neuropathic pain (NP), but has been poorly studied in patients with blood system diseases.The objective was to study the effectiveness and safety of gabapentin in patients with blood system diseases with chronic pain.Materials and methods. A single-center, prospective observational study included 24 patients with thrombocytopenia and pain between October 2017 and October 2022. The patients’ age ranged from 18 to 71 years (median 40 years). All patients with blood system diseases: non-tumor blood system diseases (aplastic anemia) in 8% (n = 2), myeloid tumor blood system diseases (acute myeloid leukemia) in 34% (n = 8), lymphoid tumor blood system diseases (acute lymphoblastic leukemia, follicular lymphoma, diffuse B – large cell lymphoma, T-cell lymphomas, multiple myeloma) in 58% (n = 14). All patients had thrombocytopenia less than 150∙109/l, 66% (n = 16) had less than 90∙109/l. All patients were diagnosed with neuropathic pain (NP), localized according to the neuroanatomical distribution and accompanied by sensory disturbances typical of NP. The localization of pain was different, pain predominated in the lower extremities (63% (n = 15), 95% CI: 43 – 79%), caused by peripheral polyneuropathy of predominantly toxic origin (vincristine, bortezomib), and pain was also caused by the course of the underlying disease: cephalalgia and neck pain, this pain was caused by compression of the nerve structures by the lymph nodes, postherpetic neuralgia, trigeminal neuralgia caused by tumor growth. All patients had intractable, high-intensity pain requiring trimeperidine at a dose of 20–40 mg/day. All patients were prescribed gabapentin therapy at a dose of 900–1200 mg/day.Results. When taking gabapentin in the study group of patients (n = 24), already on the 3rd day, there was a clinically and statistically significant decrease in pain intensity: 1) by median: from the initial 6 to 4 points, p = 0.01 (and up to 3 points by 7th day of therapy) and 2) on average: from initial 6.5 to 3.9 points, p = 0.01 (and up to 3.2 points by the 7th day). Stratification of the dynamics of pain intensity reduction by type of blood system disease (BSD) shows that the decrease by day 3 (sustained and further by day 7) was clinically and statistically significant (p = 0.01) for groups of patients with lymphoid and myeloid BSD, and clinically and approximately statistically significant in patients (n = 2) with non-tumor BSD. Analgesic therapy using small doses of gabapentin gave a pronounced, stable positive effect (pain intensity statistically significantly decreased by an average of 50%). After 7 days of gabapentin therapy, a decrease in the opioid dose was noted in 52% of patients. Side effects were dominated by drowsiness 67% (n = 16), dizziness 32% (n = 8).Conclusion. The results of this study indicate that gabapentin is effective in the treatment of chronic neuropathic pain in patients with BSD and is safe when used in minimal/average therapeutic doses within the daily dosing ranges established by the official instructions for use.

Different Gabapentin and Pregabalin Dosages for Perioperative Pain Control in Patients Undergoing Spine Surgery

Patients undergoing spine surgery often experience severe pain. The optimal dosage of pregabalin and gabapentin for pain control and safety in these patients has not been well established. To evaluate the associations of pain, opioid consumption, and adverse events with different dosages of pregabalin and gabapentin in patients undergoing spine surgery. PubMed/MEDLINE, Embase, Web of Science, Cochrane library, and Scopus databases were searched for articles until August 7, 2021. Randomized clinical trials conducted among patients who received pregabalin or gabapentin while undergoing spine surgery were included. Two investigators independently performed data extraction following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) reporting guideline. The network meta-analysis was conducted from August 2022 to February 2023 using a random-effects model. The primary outcome was pain intensity measured using the Visual Analog Scale (VAS), and secondary outcomes included opioid consumption and adverse events. Twenty-seven randomized clinical trials with 1861 patients (median age, 45.99 years [range, 20.00-70.00 years]; 759 women [40.8%]) were included in the systematic review and network meta-analysis. Compared with placebo, the VAS pain score was lowest with gabapentin 900 mg per day, followed by gabapentin 1200 mg per day, gabapentin 600 mg per day, gabapentin 300 mg per day, pregabalin 300 mg per day, pregabalin 150 mg per day, and pregabalin 75 mg per day. Additionally, gabapentin 900 mg per day was found to be associated with the lowest opioid consumption among all dosages of gabapentin and pregabalin, with a mean difference of -22.07% (95% CI, -33.22% to -10.92%) for the surface under the cumulative ranking curve compared with placebo. There was no statistically significant difference in adverse events (nausea, vomiting, and dizziness) among all treatments. No substantial inconsistency between direct and indirect evidence was detected for all outcomes. These findings suggest that gabapentin 900 mg per day before spine surgery is associated with the lowest VAS pain score among all dosages. In addition, no differences in adverse events were noted among all treatments.

Cohort study of new off-label gabapentin prescribing in chronic opioid users

IntroductionGabapentin is commonly prescribed as an off-label adjunct to opioids because of its safer risk profile. Recent evidence has shown an increased risk of mortality when coprescribed with opioids. Therefore,...

Evaluation of Gabapentin as a Treatment of Breakthrough Cancer Pain Caused by Metastatic Prostate Adenocarcinoma.

Breakthrough Cancer Pain (BTcP) is defined as a temporary increase in pain that occurs spontaneously. The use of gabapentin is believed to be able to reduce pain complaints in patients with BTcP. However, research to support the efficacy of gabapentin in relieving pain in patients with BTcP is still limited. This study aims to determine the effectiveness of the use of gabapentin in patients with BTcP caused by metastatic prostate adenocarcinoma. The study was conducted by analytic study with a prospective approach. The subjects were all patients with metastatic prostate adenocarcinoma at Zainoel Abidin General Hospital during 2022-2023 which fulfilled inclusion and exclusion criteria (30 patients). Data analysis was performed in the form of reduction in pain scale in patients with BTcP caused by metastatic prostate adenocarcinoma using gabapentin and the combination of the opioid gabapentin with T-Test. The results showed that there was no significant difference between the reduction in posttreatment pain in patients with BTcP caused by metastatic prostate adenocarcinoma taking gabapentin alone or taking the opioid gabapentin combination, either on days 3-4 or on days 5-6 (p > 0.05). However, based on the results of the evaluation on day 3-4, it was found that gabapentin was able to reduce pain by 2.2272, whereas the combination of opioid gabapentin was only able to reduce pain by 1.916. The evaluation on days 5-6 showed that gabapentin was able to reduce pain by 4.1363 and the combination of gabapentin opioids by 3.2083. The conclusion of this research is that gabapentin is effective in the treatment of BTcP caused by metastatic prostate adenocarcinoma.

A Meta-analysis of Randomized Controlled Trials Comparing the Efficacy and Safety of Pregabalin and Gabapentin in the Treatment of Postherpetic Neuralgia.

To systematically evaluate the clinical efficacy of pregabalin and gabapentin in the treatment of postherpetic neuralgia (PHN), including the difference in pain control and occurrence of adverse reactions. PubMed, MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were searched for randomized controlled trials (RCTs) comparing the efficacy of pregabalin and gabapentin in patients with PHN. Data from studies meeting the inclusion criteria were extracted and the Cochrane Risk of Bias risk assessment tool was used to evaluate the quality of the included studies. Revman 5.3 and Stata17 were used to performthe meta-analysis and to detect publication bias. A total of 14 RCTs with 3545 patients were included in this study, including 926 in the pregabalin treatment group, 1256 in the gabapentin treatment group, and 1363 in the placebo control group. Pregabalin was better than gabapentin in alleviating pain and improving the global perception of change in pain and sleep (P < 0.05). Gabapentin was associated with a lower incidence of adverse events than pregabalin (P < 0.05). Funnel plot and Begg's and Egger's tests showed no significant publication bias. Pregabalin appears to have a better overall therapeutic effect than gabapentin for patients with PHN, but gabapentin has a lower incidence of adverse reactions and a better safety profile. Clinicians should comprehensively consider patient factors and fully evaluate the advantages and disadvantages of each treatment option to select the most suitable drugs for patient use. Considering the limited quantity and quality of the existing literature, high-quality RCTs are needed to confirm the advantages of pregabalin over gabapentin in the treatment of PHN and guide clinical decision-making.

Efficacy of gabapentin for low back pain at a tertiary hospital

Objective: To assess the efficacy of gabapentin in the treatment of low back pain patients. Methods: This prospective observational study was conducted over 6 months to assess the efficacy of gabapentin in patients suffering from low back pain. Past medical history, pain severity by Visual Analogue scale (VAS) and sleep quality by Pittsburgh Sleep Quality Index (PQSI) were collected. VAS scores and PQSI scores before and after gabapentin treatment were compared, and gabapentin satisfaction post treatment were recorded. Results: This study included 100 low back pain patients with 65 males and 35 females, and the mean age was (39.0±10.5) years. The commonest presentation was non-radiating low back pain (40%). The mean VAS score and the mean PQSI score in the study before treatment were 7.70±1.91 and 10.95±5.02, respectively. After treatment with gabapentin, the mean VAS score and the mean PQSI score decreased to 2.75±1.79 and 4.90±2.20, respectively, and the differences before and after the treatment were significantly different (both P=0.001). Overall, 62% of the patients were extremely satisfied with gabapentin because they reported no adverse drug reaction. Besides, 31% of the patients were satisfied and 7%were strongly dissatisfied with the therapy. Conclusion: Gabapentin can improve sleep quality and reduce lower back pain as measured by the VAS and PQSI. The efficacy of this drug is relatively good, but further improvement is required.

Comparison of Postoperative Analgesic Effect of Magnesium Sulfate and Gabapentin in Patients Undergoing Laparoscopic Cholecystectomy

Comparison of Postoperative Analgesic Effect of Magnesium Sulfate and Gabapentin in Patients Undergoing Laparoscopic Cholecystectomy

Pregabalin and Gabapentin in Patients with Spinal Cord Injury-Related Neuropathic Pain: A Network Meta-Analysis.

IntroductionThis study was performed to explore the efficacy and safety of pregabalin and gabapentin in patients with spinal cord injury (SCI)-induced neuropathic pain to determine which treatment is most suitable for such patients.MethodsWe searched the PubMed, MEDLINE, Embase, and Cochrane Library databases from database inception to August 31, 2020. The quality of the included studies was assessed. We selected the average pain intensity after treatment and the proportion of patients who discontinued treatment because of adverse effects as the outcome indicators for efficacy and safety, respectively. Statistical analyses were performed using Stata, v16.0, and RevMan, v5.3, software.ResultsWe included eight randomized controlled trials that examined four interventions (pregabalin, gabapentin, carbamazepine, and amitriptyline). Based on the average pain intensity after treatment, the efficacy order from highest to lowest was pregabalin, gabapentin, amitriptyline, carbamazepine, and placebo. Based on the proportion of patients who discontinued treatment because of adverse effects, the order from highest to lowest was pregabalin, amitriptyline, carbamazepine, gabapentin, and placebo. In addition, five studies reported the overall incidence of treatment-related adverse effects for two interventions (pregabalin and gabapentin). According to the pooled analysis of these studies, the order for the overall incidence of treatment-related adverse effects from highest to lowest was pregabalin, gabapentin, and placebo.ConclusionsThis study revealed that for patients with SCI-related neuropathic pain, pregabalin was the most effective for relieving pain, whereas gabapentin performed better in aspects associated with drug therapy-related safety.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40122-021-00302-8.

Comparison of efficacy and safety of gabapentin and duloxetine in painful diabetic peripheral neuropathy: A systematic review and meta-analysis of randomised controlled trials.

In patients with diabetes mellitus, painful diabetic peripheral neuropathy (PDPN) is a frequent complication and can cause poor quality of life. We compared the efficacy and safety of duloxetine with those of gabapentin in patients with PDPN through a systematic review and meta-analysis of randomised controlled trials. PubMed, Embase and the Cochrane Library were searched for eligible studies published from database inception to January 2021. Visual Analogue Scale (VAS), sleep interference score, Clinical Global Impression of Change (CGIC), Patient Global Impression of Change (PGIC), Diabetic Neuropathy Symptom (DNS) score, Diabetic Neuropathic Examination (DNE) score, Neuropathic Disability Score (NDS) and side effects were used to compare duloxetine and gabapentin in patients with PDPN. Three eligible randomised controlled trials involving 290 patients were included. No significant differences were observed between patients receiving duloxetine and gabapentin with respect to VAS (mean change difference = -1.23, 95% CI, -6.09 to 3.62; P = .62), sleep interference score (mean change difference = 0.42, 95% CI, -0.15 to 1.00; P = .15), CGIC (mean difference = 0.04, 95% CI, -0.11 to 0.20; P = .60), PGIC (mean difference= 0.24, 95% CI, -0.13 to 0.60; P = .21), DNS (mean change difference = 0.14, 95% CI, -0.35 to 0.63; P = .58), DNE (mean change difference = 0.26, 95% CI, -0.35 to 0.86; P = .41) and NDS (mean change difference = 0.30, 95% CI, -0.02 to 0.63; P = .07). No significant differences were observed in the efficacy of duloxetine and gabapentin when treating patients with PDPN.

Analysis of Gabapentin's Efficacy in Tinnitus Treatment: A Systematic Review.

Tinnitus can be a chronic symptom that brings disability and distress. Some studies suggested that gabapentin might be effective on tinnitus relief. The objective of the study is to perform a systematic review in order to evaluate the efficacy of oral gabapentin in patients with tinnitus. A literature search was conducted in English and following the recommendations from PRISMA. The terms used were: ("tinnitus" OR "subjective tinnitus") AND ("gabapentin"). The study selection was performed following the eligibility criteria in accordance to the PICOS (population, intervention, comparison, outcome, study design) strategy-patients with tinnitus; oral gabapentin; placebo; reduction of tinnitus severity questionnaires scores; prospective, double-blind, randomized controlled trial, respectively. The selected studies were included in qualitative synthesis. The studies were analyzed according to Joanna Briggs Institute's critical appraisal checklist for randomized controlled trials. One hundred twenty-one studies were found in 9 databases and 8 studies were found in gray literature. After study selection, 6 articles were read in full. Then, 2 studies were excluded and 4 were included in qualitative synthesis. All 4 articles were analyzed according to critical evaluation checklist. There is insufficient evidence to recommend the use of gabapentin for patients with tinnitus.

Comparative study to evaluate the analgesic efficacy of pregabalin versus gabapentin in patients undergoing laparoscopic cholecystectomy

Comparative study to evaluate the analgesic efficacy of pregabalin versus gabapentin in patients undergoing laparoscopic cholecystectomy

Simple and rapid HPLC-UV methods for gabapentin quantification in human plasma and urine: applicability in pharmacokinetics and drug monitoring

Aim: We aimed to develop methods to determine gabapentin (GAB) in biological samples using high-performance liquid chromatography (HPLC) with application in pharmacokinetics and therapeutic drug monitoring. Methods: Simple, rapid and efficient HPLC-UV methods to quantify GAB in human plasma and urine were developed and validated for clinical analysis of GAB. The 1-fluoro-2,4-dinitrobenzene (FDNB) was used as derivatization agent. For plasma samples, protein precipitation using acetonitrile was performed, before the derivatization reaction. Urine samples were cleaned-up by liquid-liquid extraction with dichloromethane:n-butanol (1:1, v/v) after derivatized. Amlodipine besilate was used as internal standard (IS). Results: Gabapentin and IS were resolved on LiChrospher® C18 RP column and a mixture of 50 mM sodium phosphate buffer (pH 3.9):methanol (27:73, v/v) as mobile phase, at 1.2 mL/min. The methods used small sample volumes, 100 and 50 μL of plasma and urine, respectively. Linearity was obtained in the interval of 0.2-14 μg/mL in plasma and 2-120 μg/mL in urine. Both methods showed to be selective, without carry-over effect, precise, accurate and stable in different conditions. GAB plasma concentration in patients receiving 600 to 3600 mg/day of GAB ranged between 0.40 to 11.94 μg/mL at steady-state. Conclusions: The methods described in this study were simple, rapid and fulfill all validation requirements. They were easily and successfully applied for population pharmacokinetics and therapeutic drug monitoring of GAB in patients with chronic pain.

Effectiveness of pregabalin and gabapentin in patients with neuropathic pain

Effective and safe treatment of patients with neuropathic pain (NP), despite the emergence of new clinical trials, remains a challenge for clinicians. A review of epidemiological data from around the world suggests the prevalence of NP at the level of 6.9–10% in the entire population, more often in women and in the elderly [1, 2]. Chronic NP is associated with a reduced quality of life of patients. In this group of patients, anxiety, and depressive disorders as well as sleep disorders are more common [3]. Hence, effective management of patients with NP is an important problem that requires further research. The aim of the article is to present the current knowledge about pregabalin and gabapentin, their mechanisms of action, effectiveness in patients with NP, the potential risk of side effects and the risk of inappropriate use, as well as to indicate their place in the standards of neuropathic pain treatment in the light of current clinical trials.

Population pharmacokinetics of gabapentin in patients with neuropathic pain: Lack of effect of diabetes or glycaemic control.

Gabapentin (GBP) is widely used to treat neuropathic pain, including diabetic neuropathic pain. Our objective was to evaluate the role of diabetes and glycaemic control on GBP population pharmacokinetics. A clinical trial was conducted in patients with neuropathic pain (n = 29) due to type 2 diabetes (n = 19) or lumbar/cervical disc herniation (n = 10). All participants were treated with a single oral dose GBP. Blood was sampled up to 24 hours after GBP administration. Data were analysed with a population approach using the stochastic approximation expectation maximization algorithm. Weight, body mass index, sex, biomarkers of renal function and diabetes, and genotypes for the main genetic polymorphisms of SLC22A2 (rs316019) and SLC22A4 (rs1050152), the genes encoding the transporters for organic cations OCT2 and OCTN1, were tested as potential covariates. GBP drug disposition was described by a 1-compartment model with lag-time, first-order absorption and linear elimination. The total clearance was dependent on estimated glomerular filtration rate. Population estimates (between-subject variability in percentage) for lag time, first-order absorption rate, apparent volume of distribution and total clearance were 0.316 h (10.6%), 1.12 h-1 (10.7%), 140 L (7.7%) and 14.7 L/h (6.97%), respectively. No significant association was observed with hyperglycaemia, glycated haemoglobin, diabetes diagnosis, age, sex, weight, body mass index, SLC22A2 or SLC22A4 genotypes. This population pharmacokinetics model accurately estimated GBP concentrations in patients with neuropathic pain, using estimated glomerular filtrationrate as a covariate for total clearance. The distribution and excretion processes of GBP were not affected by hyperglycaemia or diabetes.

Studying the Effect of Adding Alpha Lipoic Acid to Gabapentin to Improve Nerve Conduction Velocity and Glycemic Control of Patients with Diabetic Neuropathy (Sample of Iraqi population)

Diabetic neuropathy (DN) is the most common chronic complication of diabetes mellitus. Hyperglycemia-induced oxidative stress induces programmed cell death of nerves, which contributes to the pathology of Diabetic neuropathy. Many clinical trials depend on supplement, in an attempt to improve neuropathy symptoms such as (pain &amp;&#x0D; &#x0D; tingling) and patient quality of life, one of them is alpha-lipoic acid (ALA). Alpha-lipoic acid is a potent anti-inflammatory and antioxidant with insulin-mimetic activity, it has been shown to improve clinical symptoms in experimental Diabetic neuropathy and protect peripheral nerves from ischemia, in addition to stimulate the nerve growth factor and promote fiber regeneration. This study is aimed to evaluate the effect of Alpha-lipoic acid supplement as adjuvant therapy to gabapentin in patients with diabetic neuropathy, which can reflect by the improvement in nerve conduction velocity (NCV) a test was conducted to assess the severity of iabetic neuropathy and clinical symptoms. A prospective randomized- open-label interventional study for 3 months include 33 DN patients, aged (18-69) years were divided into two groups; group A include 16 patients received gabapentin 300 mg once daily at night, and group B include 17 patients received gabapentin 300 mg once daily at night plus alpha-lipoic acid 600mg once daily. Pre and post 3 months of treatment, blood samples used to measure metabolic biomarkers (FBG, HbA1c), in addition to Nerve conduction velocity. The results showed that, the intervention group produced a highly significant change in HbA1c &amp; no significant change in FBG levels after 3months of Alpha-lipoic acid supplementation. Meanwhile, there is no significant change in HbA1c &amp; FBG levels in patients treated with gabapentin alone. Moreover, results showed highly significant improvement (P˂0.01) in Nerve conduction velocity for two groups at the end of the study. Addition of Alpha-lipoic acid to gabapentin in diabetic neuropathy patients result to improve the glycemic control &amp; Nerve conduction velocity.&#x0D; after three months of treatment.

Gabapentin Found to Work Best for Those with Severe Alcohol Withdrawal Syndrome

Gabapentin Found to Work Best for Those with Severe Alcohol Withdrawal Syndrome

Studying the Effect of Adding Alpha Lipoic Acid to Gabapentin to Improve Nerve Conduction Velocity and Glycemic Control of Patients with Diabetic Neuropathy (Sample of Iraqi population)

Diabetic neuropathy (DN) is the most common chronic complication of diabetes mellitus. Hyperglycemia-induced oxidative stress induces programmed cell death of nerves, which contributes to the pathology of Diabetic neuropathy. Many clinical trials depend on supplement, in an attempt to improve neuropathy symptoms such as (pain &amp; tingling) and patient quality of life, one of them is alpha-lipoic acid (ALA). Alpha-lipoic acid is a potent anti-inflammatory and antioxidant with insulin-mimetic activity, it has been shown to improve clinical symptoms in experimental Diabetic neuropathy and protect peripheral nerves from ischemia, in addition to stimulate the nerve growth factor and promote fiber regeneration. This study is aimed to evaluate the effect of Alpha-lipoic acid supplement as adjuvant therapy to gabapentin in patients with diabetic neuropathy, which can reflect by the improvement in nerve conduction velocity (NCV) a test was conducted to assess the severity of iabetic neuropathy and clinical symptoms. A prospective randomized- open-label interventional study for 3 months include 33 DN patients, aged (18-69) years were divided into two groups; group A include 16 patients received gabapentin 300 mg once daily at night, and group B include 17 patients received gabapentin 300 mg once daily at night plus alpha-lipoic acid 600mg once daily. Pre and post 3 months of treatment, blood samples used to measure metabolic biomarkers (FBG, HbA1c), in addition to Nerve conduction velocity. The results showed that, the intervention group produced a highly significant change in HbA1c &amp; no significant change in FBG levels after 3months of Alpha-lipoic acid supplementation. Meanwhile, there is no significant change in HbA1c &amp; FBG levels in patients treated with gabapentin alone. Moreover, results showed highly significant improvement (P˂0.01) in Nerve conduction velocity for two groups at the end of the study. Addition of Alpha-lipoic acid to gabapentin in diabetic neuropathy patients result to improve the glycemic control &amp; Nerve conduction velocity. after three months of treatment.