Gabapentin: A unique anti-epileptic agent

Abstract Gabapentin is an anti-epileptic drug (AED) that was approved in 1993 for the adjunct treatment of complex partial seizures (CPS) with and without generalization. Although the mechanism of action of gabapentin has not been fully elucidated, it has been shown to be effective not only as an adjunct AED in patients with CPS, but also in children with epilepsy, many pain syndromes (most notably neuropathic pain), and several other neurological diseases. The efficacy of the drug as an AED In both adults and children has been mostly seen when used as an adjunct with other AEDs. When used as monotherapy, it has been most effective for CPS in adults at higher doses. Gabapentin as monotherapy in children has not been shown to be as beneficial as in adults. Also, the dosing of the drug in children has been complicated by negative behavioral adverse effects. Overall, gabapentin has a low incidence of adverse effects, a pharmacokinetic profile that limits its drug interactions, and limited effects on cognition when compared to traditional AEDs. The dosing of the drug is dependent on the disease state targeted, the number of specific therapeutic drugs used, and the renal function of the patient. [Neurol Res 2001; 23: 821-829]

[1]  R. Ramsay,et al.  Gabapentin as add-on therapy in refractory partial epilepsy: a double-blind, placebo-controlled, parallel-group study. 1993. , 2001, Neurology.

[2]  P. Borusiak,et al.  Gabapentin in childhood epilepsy: a prospective evaluation of efficacy and safety , 1999, Epilepsy Research.

[3]  S. Leckband,et al.  Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain. , 1999, Archives of internal medicine.

[4]  L. Lamoreaux,et al.  Gabapentin as Add‐On Therapy in Children with Refractory Partial Seizures: A 12‐Week, Multicentre, Double‐Blind, Placebo‐Controlled Study , 1999, Epilepsia.

[5]  M. Morrell.  Dosing to Efficacy with Neurontin: The STEPS Trial , 1999, Epilepsia.

[6]  E. Zecca,et al.  Gabapentin as an adjuvant to opioid analgesia for neuropathic cancer pain. , 1999, Journal of pain and symptom management.

[7]  A. Beydoun,et al.  Gabapentin for the Symptomatic Treatment of Painful Neuropathy in Patients With Diabetes Mellitus: a Randomized Controlled Trial , 1999 .

[8]  G. Holmes,et al.  Gabapentin in the treatment of refractory partial epilepsy in children with intellectual disability. , 1998, Journal of intellectual disability research : JIDR.

[9]  D. Chadwick,et al.  A double-blind trial of gabapentin monotherapy for newly diagnosed partial seizures , 1998, Neurology.

[10]  M. Trimble,et al.  Effects of gabapentin on cognition and quality of life in patients with epilepsy , 1998, Seizure.

[11]  M. D. Merren.  Gabapentin for Treatment of Pain and Tremor: A Large Case Series , 1998, Southern medical journal.

[12]  R. Ramsay,et al.  Gabapentin bioavailability: effect of dose and frequency of administration in adult patients with epilepsy , 1998, Epilepsy Research.

[13]  J. Bruni.  Outcome Evaluation of Gabapentin as Add-on Therapy for Partial Seizures , 1998, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[14]  A. Beydoun,et al.  Conversion to High Dose Gabapentin Monotherapy in Patients with Medically Refractory Partial Epilepsy , 1998, Epilepsia.

[15]  J. Kocsis,et al.  A summary of mechanistic hypotheses of gabapentin pharmacology , 1998, Epilepsy Research.

[16]  M. Brodie,et al.  High dose gabapentin in refractory partial epilepsy: clinical observations in 50 patients , 1998, Epilepsy Research.

[17]  A. Birnbaum,et al.  Failure of Absorption of Gabapentin After Rectal Administration , 1997, Epilepsia.

[18]  F. Pea,et al.  Oral Gabapentin Disposition in Patients with Epilepsy After a High‐Protein Meal , 1997, Epilepsia.

[19]  G. Bergey,et al.  Gabapentin monotherapy: I. An 8-day, double-blind, dose controlled, multicenter study in hospitalized patients with refractory complex partial or secondarily generalized seizures , 1997, Neurology.

[20]  J. Sackellares,et al.  Gabapentin monotherapy: II. A 26-week, double-blind, dose-controlled, multicenter study of conversion from polytherapy in outpatients with refractory complex partial or secondarily generalized seizures , 1997, Neurology.

[21]  M. Brodie,et al.  Gabapentin and cognition: a double blind, dose ranging, placebo controlled study in refractory epilepsy. , 1997, Journal of neurology, neurosurgery, and psychiatry.

[22]  D. Chadwick,et al.  Gabapentin in generalized seizures , 1996, Epilepsy Research.

[23]  J. Ebersole,et al.  Gabapentin in Naive Childhood Absence Epilepsy: Results From Two Double-Blind, Placebo-Controlled, Multicenter Studies , 1996, Journal of child neurology.

[24]  G. Holmes,et al.  Efficacy of gabapentin therapy in children with refractory partial seizures. , 1996, The Journal of pediatrics.

[25]  M. Nahata,et al.  Gabapentin Associated with Aggressive Behavior in Pediatric Patients with Seizures , 1996, Epilepsia.

[26]  B. Stacey,et al.  Gabapentin and Neuropathic Pain States: A Case Series Report , 1996, Regional Anesthesia & Pain Medicine.

[27]  H. Rosner,et al.  Gabapentin adjunctive therapy in neuropathic pain states. , 1996, The Clinical journal of pain.

[28]  S. Helmers,et al.  Behavioral Side Effects of Gabapentin in Children , 1996, Epilepsia.

[29]  S. Moshé,et al.  Gabapentin Toxicity in Children Manifesting as Behavioral Changes , 1995, Epilepsia.

[30]  J. Sackellares,et al.  Gabapentin: Pharmacokinetics, Efficacy, and Safety , 1995, Clinical neuropharmacology.

[31]  B. Bourgeois.  Important Pharmacokinetic Properties of Antiepileptic Drugs , 1995, Epilepsia.

[32]  John W. Miller,et al.  Secondarily generalized seizures , 1995, Neurology.

[33]  J. Fischer,et al.  Gabapentin: A New Agent for the Management of Epilepsy , 1994, The Annals of pharmacotherapy.

[34]  T. Feuerstein,et al.  Gabapentin (Neurontin) as Add‐on Therapy in Patients with Partial Seizures: A Double‐Blind, Placebo‐Controlled Study , 1994, Epilepsia.

[35]  M. McLean.  Clinical pharmacokinetics of gabapentin , 1994, Neurology.

[36]  C. Taylor,et al.  Emerging perspectives on the mechanism of action of gabapentin , 1994, Neurology.

[37]  McLean Mj.  Clinical pharmacokinetics of gabapentin. , 1994 .

[38]  C. Taylor,et al.  Emerging perspectives on the mechanism of action of gabapentin , 1994, Neurology.

[39]  V. Trudeau,et al.  Lack of serious toxicity following gabapentin overdose , 1994, Neurology.

[40]  A. Ylinen,et al.  Double‐Blind Study of Gabapentin in the Treatment of Partial Seizures , 1991, Epilepsia.

[41]  Uk National Case-Control Study Group.  Gabapentin in partial epilepsy , 1990, The Lancet.

[42]  L. Blumhardt,et al.  Gabapentin as an antiepileptic drug in man. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[43]  M. Rowbotham,et al.  Gabapentin for the Treatment of Postherpetic Neuralgia , 2000 .

[44]  D. Lee,et al.  Gabapentin for the Treatment of Postherpetic Neuralgia , 1999 .

[45]  D. Chadwick.  Gabapentin in partial epilepsy , 1990 .