Journal d'anesthésiologie et de recherche sur la douleur

Gabapentinoids for Chronic Pain: Do the Harms Outweigh the Benefits?

Abstract

Amy Kathryn Granger

Gabapentinoids, pregabalin (LyricaTM) and gabapentin (NeurontinTM) are anticonvulsants that have been approved for chronic pain conditions such as diabetic peripheral neuropathy, postherpetic neuralgia, fibromyalgia, and are also widely prescribed off-label for chronic low back pain. Prescriptions for gabapentinoids have increased rapidly in the last five years, however, the evidence for its efficacy can be conflicting and will be analyzed for each of these chronic pain conditions. The adverse event rates and safety profile will be examined, including case reports of the occurrence of serious adverse events, to ascertain whether gabapentinoids have the potential to cause harm above the benefit of providing effective pain relief. Further case reports documenting serious withdrawal syndromes will add to the body of evidence to weigh the benefits over the risks and will identify areas where research is lacking. From the analysis of evidence on efficacy, adverse events and withdrawal there will be resulting recommendations for practice when considering gabapentinoid treatment for chronic pain.