Gabapentin for neuropathic cancer pain

Objective: In this study, the analgesic effect of gabapentin used in combination with opioids was assessed in neuropathic cancer pain. Material and Methods: A total of 27 cancer patients diagnosed to have neuropathic pain were included in the study. Patients' general pain complaints were accompanied with burning, shooting pain and allodynia. Gabapentin was used as an adjunctive agent in addition to the opioid analgesic treatment. Gabapentin's daily dose was titrated to the target level within 3-to-7 days. All complaints of the patients including pain and allodynia were assessed by visual analogue scale (VAS) in 10-day intervals. After three assessment points (i.e. 30 days), the data collection was completed. Results: Fourteen female and 13 male patients were enrolled in the study. The mean age was 53.81 +/- 13.45 years, and their cancer diagnostics were as follows: lung (n=13), breast (n=9), multiple myeloma (n=2), tumor of soft tissue (n=2), rectum cancer (n=1). For the opioid treatment, codein 160 mg(-1) day, tramadol 150 mg(-1) day, and fentanyl 100 mu gr(-1) h were prescribed to the patients. Mean dose of gabapentin was 1204 +/- 272 mg(-1) day (600-1600 mg(-1) day). Pain VAS/Allodynia VAS ratios were as follows: 1(st) control; 9 +/- 1.38/7.92 +/- 2.2, 2(nd) control; 6.51 +/- 2.04/5.18 +/- 2.13, and the 3(rd) control 4.07 +/- 2.11/3.22 +/- 2.27. The decrease in the VAS values within time was significantly different (p < 0.0001). Adverse effects of the treatment regimen were as follows: Drowsiness and short-term memory problems (n=5), nausea-vomiting (n=2). Conclusion: Gabapentin seems to have an important role as an adjunctive treatment option in addition to opioids.