Investigation of the use of gabapentinoid drugs in pain management

Abstract

Objectives: This study aimed to investigate the kind of painful conditions and preferred drug doses for which gabapentinoids were used for pain management for the musculoskeletal and nervous systems. Materials and Methods: The study included 364 patients over the age of 18 who applied to the physical therapy and rehabilitation outpatient clinic with complaints of musculoskeletal and nervous system pain. Demographic characteristics of the patients including age, gender, body mass index, smoking, disease diagnoses, preferred gabapentinoid drug, and dosage were recorded. Moreover, the estimation of the severity of pain by the Visual Analog Scale (VAS) before and 6 months after the treatments was collected from medical records. Results: The mean age of the patients was 59.54 ± 11.59 years and 82.1% were female and 17.9% were male. The diseases preferred for drug use were lumbar disc herniation (39.3%), cervical disc herniation (13.7%), spondylolisthesis (11.3%), diabetic neuropathy (11%), frozen shoulder (10.7%), gonarthrosis (10.4%), psoriatic arthritis (8.5%), spondylosis (8%), fibromyalgia (4.9%), carpal tunnel syndrome (4.7%), complex regional pain syndrome (2.7%), restless leg syndrome (1.1%), coxarthrosis (0.8%), postherpetic neuralgia (0.8%), and hemiplegia (0.5%), respectively. There was significant female gender superiority in both pregabalin and gabapentin groups ( P < 0.001). In whole chronic pain conditions, the VAS scores before and after 6 months of treatment were significantly reduced in both groups, except for restless legs syndrome ( P = 0.066). According to the results of the study, it was determined that the indication for gabapentinoid use was mainly related to neuropathic pain and gabapentinoid doses were below the recommended amounts. Conclusion: Originally developed as anticonvulsants, gabapentin, and pregabalin are increasingly used in the treatment of various types of pain, including neuropathic and musculoskeletal pain. Although they raise concerns about addiction, it should not be overlooked that gabapentinoids are useful in the treatment of chronic painful conditions when used in the correct indications and doses.