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Author: Admin | 2025-04-28
Although used widely in pain disorders, it only has clear benefits in post-herpetic neuralgia and diabetic peripheral neuropathy, and is not considered effective for low back pain, sciatica, spinal stenosis, or migraines (Mathieson S et al, BMJ 2020;369:m1315). Gabapentin’s RLS approval is reserved for gabapentin enacarbil (Horizant), a prodrug that delays absorption by attaching the medication to an enacarbil molecule.Pruritus (Chronic Itching): Gabapentin has shown effectiveness in managing severe itching related to conditions like kidney disease, liver disease, or certain types of neuropathy.Chronic Cough: Some cases of refractory chronic cough, where traditional treatments are ineffective, have responded to gabapentin.Multiple Sclerosis (MS)-Related Symptoms: Gabapentin can help alleviate nerve pain, spasticity, and certain types of tremors associated with MS.Temporomandibular Joint (TMJ) Disorders: In cases of chronic TMJ-related pain, gabapentin may be used to reduce discomfort.Post-Traumatic Stress Disorder (PTSD): It is sometimes prescribed to help manage PTSD symptoms, particularly anxiety, sleep disturbances, and hyperarousal.Vulvodynia: Gabapentin can help reduce pain in patients with vulvodynia, a chronic pain condition affecting the vulvar region.Phantom Limb Pain: After amputation, some patients experience pain in the “phantom” limb, and gabapentin may be used to help relieve these sensations.Chronic Pelvic Pain: Gabapentin is sometimes prescribed to help manage chronic pelvic pain, especially when associated with nerve involvement.Trigeminal Neuralgia: Although more commonly used for postherpetic neuralgia, gabapentin can also help with trigeminal neuralgia, a painful nerve condition affecting the face.Addiction Treatment: Despite concerns about gabapentin misuse, the medication does have a role in alcohol and cannabis use disorders. Patients who take it for alcohol use disorders report fewer days of heavy drinking, with an effect size in the medium range (0.4) from seven randomized controlled trials (Ahmed S et al, Prim Care Companion CNS Disord 2019;21(4):19r02465). Gabapentin also improves sleep quality during recovery from alcohol use. The dose range was 300–3600 mg/day, with most settling in around 900 mg/day. Gabapentin may also be useful for alcohol withdrawal, but with a caveat. Although it was generally effective in controlled trials that compared it with benzodiazepines and phenobarbital, there were a few seizures during the gabapentin taper—not enough to raise statistical alarms,
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