Gabapentin for Treatment of Pain and Tremor

BACKGROUND: Several anticonvulsant agents, including carbamazepine, phenytoin, and valproate, are effective in some patients for the treatment of pain and tremor. This study reports on a trial of the newly introduced anticonvulsant, gabapentin, for pain and tremor control. METHODS: A large case series of patients with centrally mediated pain, peripherally mediated pain, migraine, and tremor were treated in an open-label study with gabapentin (maximum of 2,700 mg/day). RESULTS: Thirty-nine patients (65%) had moderate-to-excellent improvement in symptoms, with the best responses occurring in patients with peripherally mediated neuropathic pain. The other conditions treated that showed some improvement were benign essential/familial tremor, restless legs syndrome, centrally mediated pain, and periodic nighttime leg movements. CONCLUSIONS: Gabapentin offers an effective, safe alternative therapy or co-therapy for the listed painful conditions and tremor; it does not affect the metabolism of other medications and is well tolerated.