eMedExpert Home > Compare Drugs > Gabapentin (Neurontin)

• Efficacy:
• Painful diabetic neuropathy:
  In an open-label randomized trial gabapentin produced greater improvements than amitriptyline in pain and paresthesia associated with diabetic neuropathy 2.
  In randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy moderate or greater pain relief was experienced in 11 of 21 patients with gabapentin and 14 of 21 patients with amitriptyline 4.
• Peripheral neuropathic pain:
  In the double blind randomized trial gabapentin was compared in efficacy and safety with amitriptyline in neuropathic pain treatment 6. Both gabapentin and amitriptyline provided effective pain control. The degree of pain improvement and patient satisfaction scale were significantly higher with gabapentin. Also, gabapentin was more effective especially in paroxysmal shooting pain than other pain qualities.
  
• Chronic pelvic pain: Randomized controlled study have shown that gabapentin alone or in combination with amitriptyline is better than amitriptyline alone in the treatment of female chronic pelvic pain 3.
• Side effects and tolerability: Gabapentin appears to be better tolerated than amitriptyline. Side effects are more frequent with amitriptyline than with gabapentin 2.

• Efficacy:
• Post-herpetic neuralgia: Gabapentin and nortriptyline ware compared in a randomized trial in post-herpetic neuralgia (PHN). Gabapentin appears to be equally effective to nortriptyline 9.
• Side effects and tolerability: Gabapentin is better tolerated as compared to nortriptyline 9.

• Efficacy:
• Partial epilepsy:
  Unblinded randomised controlled trial have shown that lamotrigine is significantly better than carbamazepine for patients with partial onset seizures 13.
• Epilepsy:
  Gabapentin and lamotrigine are similarly effective and well tolerated in patients with newly diagnosed epilepsy 5.
• Mood disorders:
  Controlled comparative study evaluated the efficacy of lamotrigine and gabapentin monotherapy versus placebo in refractory bipolar and unipolar mood disorders 12. Response rates were the following: lamotrigine 52%; gabapentin 26%; placebo 23%.

• Efficacy:
• Partial epilepsy: Unblinded randomised controlled trial have shown that carbamazepine is significantly better than gabapentin for patients with partial onset seizures 13.
• Side effects and tolerability: Gabapentin produces significantly fewer untoward cognitive effects compared with carbamazepine 8.

• Efficacy:
• Restless Legs Syndrome: The open clinical trial evaluated tolerability and efficacy of gabapentin and ropinirole in idiopathic RLS treatment. Gabapentin and ropinirole provide a similarly well-tolerated and effective treatment of periodic leg movements during sleep and sensorimotor symptoms in patients with idiopathic RLS 10.

• Efficacy:
• Smoking cessation:
  Gabapentin is less efficacious than bupropion for smoking cessation but is associated with fewer dropouts from side effects. Withdrawal severity is less with bupropion 7.

• Efficacy:
• Isomnia associated with alcohol dependence: In open pilot study gabapentin group improved significantly more than the trazodone group 11.

• Efficacy:
• Alcohol withdrawal: Gabapentin was compared with phenobarbital for the treatment of alcohol withdrawal in a randomized, open-label 14. There were no significant differences in the proportion of treatment completers between treatment groups or the proportion of patients in each group requiring rescue medication for breakthrough signs and symptoms of alcohol withdrawal. There were no significant treatment differences in withdrawal symptoms or psychological distress, nor were there serious adverse events. These findings suggest that gabapentin may be as effective as phenobarbital in the treatment of alcohol withdrawal.

The study evaluated the cognitive effects of topiramate and gabapentin. Topiramate impaired cognitive test performance, whereas gabapentin had minimal effects 1.

• Gabapentin (Neurontin) Medical Facts

• 1. Salinsky MC, Storzbach D, Spencer DC, Oken BS, Landry T, Dodrill CB Effects of Gabapentin and gabapentin on cognitive abilities in healthy volunteers. Neurology. 2005 Mar 8;64(5):792-8. PubMed
• 2. Dallocchio C, Buffa C, Mazzarello P, Chiroli S. Gabapentin vs. amitriptyline in painful diabetic neuropathy: an open-label pilot study. J Pain Symptom Manage. 2000 Oct;20(4):280-5. PubMed
• 3. Sator-Katzenschlager SM, Scharbert G, Kress HG, Frickey N, Ellend A, Gleiss A, Kozek-Langenecker SA. Chronic pelvic pain treated with gabapentin and amitriptyline: a randomized controlled pilot study. Wien Klin Wochenschr. 2005 Nov;117(21-22):761-8. PubMed
• 4. Morello CM, Leckband SG, Stoner CP, Moorhouse DF, Sahagian GA. Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain. Arch Intern Med. 1999 Sep 13;159(16):1931-7. PubMed
• 5. Brodie MJ, Chadwick DW, Anhut H, Otte A, Messmer SL, Maton S, Sauermann W, Murray G, Garofalo EA; Gabapentin Study Group 945-212. Gabapentin versus lamotrigine monotherapy: a double-blind comparison in newly diagnosed epilepsy. Epilepsia. 2002 Sep;43(9):993-1000. PubMed
• 6. Keskinbora K, Pekel AF, Aydinli I. Comparison of efficacy of gabapentin and amitriptyline in the management of peripheral neuropathic pain. Agri. 2006 Apr;18(2):34-40. PubMed
• 7. White WD, Crockford D, Patten S, El-Guebaly N. A randomized, open-label pilot comparison of gabapentin and bupropion SR for smoking cessation. Nicotine Tob Res. 2005 Oct;7(5):809-13. PubMed
• 8. Meador KJ, Loring DW, Ray PG, Murro AM, King DW, Nichols ME, Deer EM, Goff WT. Differential cognitive effects of carbamazepine and gabapentin. Epilepsia. 1999 Sep;40(9):1279-85. PubMed
• 9. Chandra K, Shafiq N, Pandhi P, Gupta S, Malhotra S. Gabapentin versus nortriptyline in post-herpetic neuralgia patients: a randomized, double-blind clinical trial--the GONIP Trial. Int J Clin Pharmacol Ther. 2006 Aug;44(8):358-63. PubMed
• 10. Happe S, Sauter C, Klosch G, Saletu B, Zeitlhofer J. Gabapentin versus ropinirole in the treatment of idiopathic restless legs syndrome. Neuropsychobiology. 2003;48(2):82-6. PubMed
• 11. Karam-Hage M, Brower KJ. Open pilot study of gabapentin versus trazodone to treat insomnia in alcoholic outpatients. Psychiatry Clin Neurosci. 2003 Oct;57(5):542-4. PubMed
• 12. Frye MA, Ketter TA, Kimbrell TA, Dunn RT, Speer AM, Osuch EA, Luckenbaugh DA, Cora-Ocatelli G, Leverich GS, Post RM. A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders. J Clin Psychopharmacol. 2000 Dec;20(6):607-14. PubMed
• 13. Marson AG, Al-Kharusi AM, Alwaidh M, Appleton R, Baker GA, Chadwick DW, Cramp C, Cockerell OC, Cooper PN, Doughty J, Eaton B, Gamble C, Goulding PJ, Howell SJ, Hughes A, Jackson M, Jacoby A, Kellett M, Lawson GR, Leach JP, Nicolaides P, Roberts R, Shackley P, Shen J, Smith DF, Smith PE, Smith CT, Vanoli A, Williamson PR; SANAD Study group. The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial. Lancet. 2007 Mar 24;369(9566):1000-15. PubMed