Gabapentin is an anti-epileptic medication, also called an anticonvulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain.
Gabapentin is used in adults to treat nerve pain caused by herpes virus or shingles (herpes zoster).
Neuropathic pain comes from damaged nerves. It is different from pain messages that are carried along healthy nerves from damaged tissue (for example, from a fall or cut, or arthritic knee). Neuropathic pain is often treated by different medicines (drugs) to those used for pain from damaged tissue, which we often think of as painkillers. Medicines that are sometimes used to treat depression or epilepsy can be effective in some people with neuropathic pain. One of these is gabapentin. Our definition of a good result was someone with a high level of pain relief and able to keep taking the medicine without side effects making them stop.
In January 2017 we searched for clinical trials in which gabapentin was used to treat neuropathic pain in adults. We found 37 studies that satisfied the inclusion criteria, randomising 5914 participants to treatment with gabapentin, placebo, or other drugs. Studies lasted 4 to 12 weeks. Most studies reported beneficial outcomes that people with neuropathic pain think are important. Results were mainly in pain after shingles and pain resulting from nerve damage in diabetes.
In pain after shingles, 3 in 10 people had pain reduced by half or more with gabapentin and 2 in 10 with placebo. Pain was reduced by a third or more for 5 in 10 with gabapentin and 3 in 10 with placebo. In pain caused by diabetes, 4 in 10 people had pain reduced by half or more with gabapentin and 2 in 10 with placebo. Pain was reduced by a third or more for 5 in 10 with gabapentin and 4 in 10 with placebo. There was no reliable evidence for any other type of neuropathic pain.
Side effects were more common with gabapentin (6 in 10) than with placebo (5 in 10). Dizziness, sleepiness, water retention, and problems with walking each occurred in about 1 in 10 people who took gabapentin. Serious side effects were uncommon, and not different between gabapentin and placebo. Slightly more people taking gabapentin stopped taking it because of side effects.
Gabapentin is helpful for some people with chronic neuropathic pain. It is not possible to know beforehand who will benefit and who will not. Current knowledge suggests that a short trial is the best way of telling.
Quality of the evidence
The evidence was mostly of moderate quality. This means that the research provides a good indication of the likely effect. The likelihood that the effect will be substantially different is moderate.
The Horizant brand of gabapentin is also used to treat restless legs syndrome (RLS).The Neurontin brand of gabapentin is also used to treatseizures in adults and children who are at least 3 years old.
Gabapentin is also be used to treat following health conditions:
- Alcohol Withdrawal
- Benign Essential Tremor
- Bipolar Disorder
- Burning Mouth Syndrome
- Cluster-Tic Syndrome
- Diabetic Peripheral Neuropathy
- Hot Flashes
- Lhermitte’s Sign
- Nausea/Vomiting, Chemotherapy Induced
- Neuropathic Pain
- Occipital Neuralgia
- Periodic Limb Movement Disorder
- Peripheral Neuropathy
- Postherpetic Neuralgia
- Postmenopausal Symptoms
- Pudendal Neuralgia
- Reflex Sympathetic Dystrophy Syndrome
- Restless Legs Syndrome
- Small Fiber Neuropathy
- Transverse Myelitis
- Trigeminal Neuralgia