Gabapentin for Neuropathic Cancer Pain

Gabapentin capsules, tablets, and oral solution are used along with other medications to help control certain types of seizures in people who have epilepsy.

Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles).

Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down).

Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.

Gabapentin for Neuropathic Cancer Pain

Neuropathic pain is frequently diagnosed as a complication of cancer pain. While opioids are the mainstay of cancer pain management, their efficacy in neuropathic pain seems to be less then optimal, and adjuvant drugs, mainly anticonvulsants and antidepressants, are often combined with opioids in the analgesic regimen of patients with neuropathic cancer pain.

This approach is suggested by well-established guidelines, but the analgesic benefit of this practice is poorly documented. Among new-generation anticonvulsants, gabapentin has been used in anecdotal experiences as adjuvant treatment for cancer pain with a neuropathic component, in combination with opioid analgesics.

Gabapentin is an anticonvulsant structurally related to gamma aminobutyric acid, which has analgesic effects in several experimental and clinical models of nonmalignant chronic neuropathic pain. These effects seem to be as a result of a specific antihyperalgesic activity. Experimental and clinical data also suggest that gabapentin can be used to enhance morphine analgesia.

The aim of this study was to assess the efficacy and safety of the addition of gabapentin to opioids in the treatment of patients with neuropathic pain due to neoplasm that was not completely controlled by systemic opioid administration.