The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists
-
To provide current information regarding the efficacy and tolerability of the anticonvulsant gabapentin in the management of neuropathic pain. ⋯ In human pain models using patients with neuropathic pain, gabapentin has been found effective against both spontaneous and evoked pain, and these effects are independent of the pain source. Gabapentin, in doses ranging up to 3.6 g/day, has demonstrated efficacy in a variety of neuropathic pain states, including those refractory to agents such as the tricyclic antidepressants (TCA) and other anticonvulsants. A major question today is whether gabapentin should be considered as first-line therapy (i.e., even before a trial of a TCA or carbamazepine) or as second-line therapy for individuals unresponsive to or intolerant of TCAs and/or carbamazepine.