Share on Facebook Share on Twitter Email
Answers.com

Gabapentin

 
Neurological Disorder:

Gabapentin

Home > Library > Health > Neurological Encyclopedia

Definition

Gabapentin is a prescription drug that was initially approved to help manage epilepsy. The Food and Drug Administration (FDA) has also approved gabapentin for treatment of the nerve pain that sometimes accompanies herpes infections. Gabapentin is available in the United States under the trade name Neurontin.

Purpose

Although the FDA has only approved gabapentin for managing epilepsy and treating nerve pain associated with herpes infections, doctors often prescribe the medication for managing other conditions, including tremors associated with multiple sclerosis, nerve pain, bipolar disorder, and migraine prevention.

Description

As an antiepileptic drug, gabapentin may be used in conjunction with other drugs to prevent partial seizures. Partial seizures are caused by brief abnormal electrical activity in localized areas of the brain. Partial seizures usually do not cause unconsciousness, but may cause rhythmic contractions in one area of the body or abnormal numbness or tingling sensations.

Although gabapentin was originally approved by the FDA in 1993, it is still not understood how gabapentin prevents seizures. However, the drug is related to gamma-aminobutyric acid (GABA), a neurochemical that possesses inhibitory properties. In brain cells, these inhibitory actions prevent excitatory electrical impulses from spreading to neighboring cells. As a result, gabapentin probably prevents the spread of abnormal excitatory activity in the brain at least in part, by mimicking the actions of GABA.

By preventing excitatory communication between cells, gabapentin may also inhibit the electrical impulses involved in pain conduction. This may account for the drug's ability to alleviate pain, especially nerve pain.

When gabapentin is used along with other therapies for managing epileptic partial seizures, improvements should be observed within 12 weeks. On the other hand, pain relief may be evident within one week when the drug is used for pain associated with herpes infections.

Recommended dosage

For adults, the initial dose of gabapentin is 300 mg taken by mouth three times each day. The dosage may be increased if necessary. Dosages as high as 800–1,200 mg three times daily have been well tolerated.

In children three to 12 years of age, the starting dose should be 10–15 mg/2.2 lb (1 kg)/day given in three equal doses. This dose can be increased until an effective dosage is reached, typically 25–40 mg/2.2 lb (1 kg)/day. Lower dosages are required for patients that have kidney disease.

Precautions

In children, gabapentin may cause behavioral and emotional disorders. The drug should be used cautiously and the dosage should be reduced in those with severe kidney disease. In experimental animals, gabapentin caused tumors to develop; however, it is not known if this occurs in humans.

Patients should take gabapentin only as prescribed. The drug should never be stopped abruptly because doing so increases the likelihood of having a seizure. Since gabapentin can cause dizziness and fatigue, patients should avoid driving or operating complex machinery until they know whether the drug adversely affects their reaction time or impairs their judgment.

Side effects

The most common side effects that cause adults to stop taking gabapentin are dizziness, sleepiness, fatigue, shaky movements, difficulty walking, or swelling in the ankles.

In children, the side effects the drug may cause include emotional problems, hostility, and hyperactivity.

Interactions

Unlike many other drugs that are used to treat epilepsy, there are few drug interactions associated with gabapentin. It is recommended, however, that antacids not be used sooner than two hours after gabapentin to avoid compromising gabapentin's effectiveness.

Resources

BOOKS

Drug Facts and Comparisons, 6th edition. St. Louis, MO: A Wolter Kluwer Company, 2002.

Mosby's Medical Drug Reference. St. Louis, MO: Mosby, Inc, 1999.

Neurontin Package Insert. Vega Baja, PR: Parke-Davis Pharmaceuticals, Ltd., 2002.


Kelly Karpa, PhD, RPh


Search unanswered questions...

Enter a question here...
Search: All sources Community Q&A Reference topics

Oncology Encyclopedia:

Gabapentin

Top
Home > Library > Health > Oncology Encyclopedia

Key Terms: Bipolar disorder, Diabetic neuropathy, Multiple sclerosis, Postherpetic neuralgia.

Definition

Gabapentin is indicated to be used in combination with other anti-seizure (anticonvulsant) drugs for the management of partial seizure types. Gabapentin should not be used alone for the treatment of seizures unless the patient cannot tolerate other anticonvulsant drugs. This medication can also be used for the treatment of certain syndromes associated with nerve (neuropathic) pain (diabetic neuropathy, postherpetic neuralgia), pain associated with multiple sclerosis, neuropathic cancer pain, trigeminal neuralgia, and bipolar mood disorder. Gabapentin is also known as Neurontin.

Description

Gabapentin was introduced in 1994 as an anticonvulsant medication. Other medications in the anticonvulsant class include phenytoin, carbamazepine, phenobarbital, valproic acid, topiramate, and lamotrigine. Gabapentin's structure is similar to that of gamma-aminobutiric acid (GABA), which is a chemical found in the central nervous system (brain and spinal cord) that decreases firing of neurons leading to a decrease in seizure activity. Despite this structural similarity, gabapentin does not interact with GABA receptors and its exact mechanism of action for either epilepsy or pain is not known.

Gabapentin is a relatively recent addition to the arsenal of drugs used in the treatment of neuropathic pain. Traditionally, tricyclic antidepressants (amitriptyline, nortriptyline, desipramine) have been used as first-line agents. It takes one to three weeks for either gabapentin or tricyclic antidepressants (TCAs) to provide relief of pain after starting treatment. Gabapentin appears to be a safer agent to use than TCAs, especially in elderly patients and patients on multiple other medications. One of the disadvantages of gabapentin over TCAs is its higher cost.

Recommended Dosage

Adults and Children Over 12 Years of Age

Management of Partial Seizure Types

Therapy should be started at a dose of 300 mg, three times daily. The dose can be increased to 1,800 mg/day in three divided doses. Some patients may need even higher doses to control their seizures. Doses up to 3,600 mg per day have been well tolerated in research studies.

Treatment of Neuropathic Pain

Dosages of 300-3,600 mg/day have been effective in research studies. However, optimal dosage appears to be 1,200-2,400 mg/day divided in three doses.

Treatment of Bipolar Disorder

Optimal dose has not been well established. Doses up to 4,800 mg/day have been used.

Children Less Than 12 Years of Age

Dosage varies due to the child's size, weight, and extent of condition. Parents should ask their physician about appropriate dosage levels for their child.

Administration

To minimize side effects, the first dose should be taken at bedtime. Capsules should not be chewed or crushed. Patients should avoid taking antacids (Mylanta, Maalox) at the same time as gabapentin. Doses should be taken at even intervals, and if a dose is missed, it should be taken as soon as remembered. However, double-doses can be hazardous and should be avoided.

Precautions

Gabapentin should be used with caution by breast-feeding mothers, children under 12 years of age (because of a lack of safety and efficacy studies in this population), and patients with impaired kidney function.

Gabapentin has resulted in fetal abnormalities in mice, rats, and rabbit offsprings. There are no current studies on gabapentin use in pregnant women. This drug should only be used during pregnancy if potential benefits justify the risk to the baby.

This medication should not be discontinued suddenly because of the possibility of increased frequency of seizures. Gabapentin doses should be decreased gradually over a period of at least one week.

Gabapentin may cause drowsiness and dizziness. Alcoholic beverages may intensify these effects and their intake should be limited. Patients should use caution when driving, operating dangerous machinery, or performing activities requiring alertness.

A patient experiencing any of the following should contact their physician or pharmacist immediately:

  • mental or mood changes
  • tingling or numbness of hands or feet
  • swelling of ankles
  • vision problems
  • fever or unusual bleeding

Side Effects

This medication is usually well tolerated. Nervous system side effects are the most common, including drowsiness, dizziness, unsteadiness when walking, fatigue, and vision changes (double-vision, blurred vision). These side effects appear to be dose-related, and some patients may develop tolerance to these effects after the first several weeks of therapy. If these side effects persist or worsen, a physician should be notified. Other side effects that occur less frequently are irritability, dyspepsia, mood changes, memory loss, difficulty concentrating, slurred speech, and impotence. Elderly patients may be more sensitive to the side effects of gabapentin.

Interactions

One of the advantages of gabapentin is that it is not broken down in the body and does not have a lot of drug interaction. Antacids may interfere with the absorption of this medication in the body; they should be taken at least two hours apart. Gabapentin does not effect other commonly used anticonvulsants (for example, phenytoin, carbamazepine, valproic acid, and phenobarbital).

—Olga Bessmertny, Pharm.D.

Dental Dictionary:

gabapentin

Top
Home > Library > Health > Dental Dictionary

n

trade name: Neurontin; drug class: anticonvulsant; action: anticonvulsant action is unclear; use: adjunctive therapy in adults with partial seizures.

Drug Info:

Gabapentin

Top
Home > Library > Health > Drug Info

Brand names: Gabarone™Neurontin®

Chemical formula:



Gabapentin Oral tablet

What is this medicine?

GABAPENTIN (GA ba pen tin) is used to control partial seizures in adults with epilepsy. It is also used to treat certain types of nerve pain.
 
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•kidney disease
•suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
•an unusual or allergic reaction to gabapentin, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

Take this medicine by mouth. Swallow it with a drink of water. Follow the directions on the prescription label. If this medicine upsets your stomach, take it with food or milk. Take your medicine at regular intervals. Do not take it more often than directed.

If you are directed to break the 600 or 800 mg tablets in half as part of your dose, the extra half tablet should be used for the next dose. If you have not used the extra half tablet within 3 days, it should be thrown away.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

•antacids
•hydrocodone
•morphine
•naproxen
•sevelamer

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. You may want to keep a record at home of how you feel your condition is responding to treatment. You may want to share this information with your doctor or health care professional at each visit. You should contact your doctor or health care professional if your seizures get worse or if you have any new types of seizures. Do not stop taking this medicine or any of your seizure medicines unless instructed by your doctor or health care professional. Stopping your medicine suddenly can increase your seizures or their severity.
 
Wear a medical identification bracelet or chain if you are taking this medicine for seizures, and carry a card that lists all your medications.
 
You may get drowsy, dizzy, or have blurred vision. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. To reduce dizzy or fainting spells, do not sit or stand up quickly, especially if you are an older patient. Alcohol can increase drowsiness and dizziness. Avoid alcoholic drinks.
 
Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water will help.
 
The use of this medicine may increase the chance of suicidal thoughts or actions. Pay special attention to how you are responding while on this medicine. Any worsening of mood, or thoughts of suicide or dying should be reported to your health care professional right away.
 
Women who become pregnant while using this medicine may enroll in the North American Antiepileptic Drug Pregnancy Registry by calling 1-888-233-2334. This registry collects information about the safety of antiepileptic drug use during pregnancy.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•worsening of mood, thoughts or actions of suicide or dying

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•constipation
•difficulty walking or controlling muscle movements
•nausea
•slurred speech
•tremors
•weight gain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Wikipedia:

Gabapentin

Top
Home > Library > Miscellaneous > Wikipedia
Gabapentin
Systematic (IUPAC) name
2-[1-(aminomethyl)cyclohexyl]acetic acid
Identifiers
CAS number 60142-96-3
ATC code N03AX12
PubChem 3446
DrugBank APRD00015
Chemical data
Formula C9H17NO2 
Mol. mass 171.237 g/mol
Pharmacokinetic data
Bioavailability Rapid, in part by saturable carrier-mediated L-amino acid transport system
60% for 0.9 g daily to 27% for 4.8 g daily dose
Food increases absorption by 14%
Protein binding Less than 3%
Metabolism Not appreciably metabolized
Half life 5 to 7 hours
Excretion Renal
Therapeutic considerations
Pregnancy cat. B1(AU) D(US) Benefit of treatment may outweigh risk to fetus. Risk of teratogenicity greater if more than one drug used[1]
Legal status POM (UK) ℞ Prescription only
Routes Oral
 Yes check.svgY(what is this?)  (verify)

Gabapentin (brand name Neurontin) is a GABA analogue. It was originally developed for the treatment of epilepsy, and currently, gabapentin is widely used to relieve pain, especially neuropathic pain.[2]

Contents

Pharmacology

Gabapentin was initially synthesized to mimic the chemical structure of the neurotransmitter gamma-aminobutyric acid (GABA), but is not believed to act on the same brain receptors.

Its exact mechanism of action is unknown, but its therapeutic action on neuropathic pain is thought to involve voltage-gated N-type calcium ion channels. It is thought to bind to the α2δ subunit (1 and 2)[3] of the voltage-dependent calcium channel in the central nervous system.[4]

Indications

Due to the wide variety of conditions for which Gabapentin may be considered as a treatment, and the various claims and counterclaims surrounding it, this presentation of the indicated uses of Gabapentin has attempted to separate the FDA accepted uses, the putative uses, and the disputed uses of the drug.

A capsule of gabapentin

Proven

Gabapentin was originally approved in the U.S. by the Food and Drug Administration (FDA) in 1994 for use as an adjunctive medication to control partial seizures (effective when added to other antiseizure drugs). In 2002, an indication was added for treating postherpetic neuralgia (neuropathic pain following shingles), other painful neuropathies, and nerve related pain.[5]

Gabapentin (administered orally) is one of two medications (the other being flumazenil, which is administered intravenously) used in the expensive Prometa Treatment Protocol for methamphetamine, cocaine and alcohol addiction. Gabapentin is administered at a dosage of 1200 mg taken at bedtime for 40–60 days. Though the combination of flumazenil infusions and gabapentin tablets is a licensed treatment, there is no prohibition against a physician prescribing gabapentin outside the Prometa protocol. There have been reports by methamphetamine addicts that gabapentin alone in doses of 1200 mg at bedtime taken for 40–60 days has been effective in reducing the withdrawal symptoms and almost eliminating cravings or desire to use methamphetamine.[6] It also helps those addicted to prescribed pain medications, and reduces withdrawal symptoms. [7], [8]

Positive

Gabapentin is frequently used to treat various types of Neuralgia. It has been found to be effective in prevention of frequent migraine headaches,[9] neuropathic pain[10] and nystagmus,[11] and is prescribed off-label (that is, without formal regulatory agreement) for these conditions. Gabapentin is widely believed to help patients with post-operative chronic pain (usually caused by nerves that have been severed accidentally in an operation and when grown back, have reconnected incorrectly) and nerve pain associated with spinal cord injury. It may be effective in reducing pain and spasticity in multiple sclerosis.[12], and has also had success in treating certain instances of Complex Regional Pain Syndrome.[13][14]

It is not uncommon for the prescription of Gabapentin to occur in a mental health context. It has been investigated as a mood-stabilizing treatment for bipolar disorder with the potential therapeutic advantage of having fewer side-effects than better established bipolar drugs such as lithium and valproic acid although numerous trials have shown that it is not effective. Gabapentin has limited usefulness in the treatment of anxiety disorders such as social anxiety disorder and obsessive-compulsive disorder, in treatment-resistant depression, and for insomnia.[15][16]

Additionally, Gabapentin has been prescribed to menopausal patients being treated with anti-androgenic compounds to reduce the incidence and intensity of the accompanying hot flashes[17]. It has occasionally been prescribed for treatment of idiopathic subjective tinnitus, although a double blind, randomized controlled trial has found this ineffective.[18] Gabapentin may help deepen sleep, positively affecting deep, slow wave sleep, and reducing arousals during the night [19].[citation needed] It could potentially be helpful for both sleep onset and sleep maintenance.[citation needed] Gabapentin is sometimes prescribed for RLS (Restless Legs Syndrome). Finally, it may be effective in treating akathisia - a side effect of antipsychotics that causes severe agitation and anxiety.[citation needed]

Gabapentin has also been used to treat some symptoms of opiate withdrawal.[20]

Negative

There has been a growing controversy regarding the psychiatric off-label use of Gabapentin.[12] Although some small, non-controlled studies in the 1990s — mostly sponsored by gabapentin's manufacturer — suggested that gabapentin treatment for bipolar disorder may be promising,[12] other more recent and better controlled studies have found it to be no more effective (and in one study, slightly less effective) than placebo.[21] Subsequent to the corporate acquisition of the original patent holder, the pharmaceutical company Pfizer admitted that there had been violations of FDA guidelines regarding the promotion of unproven off-label uses for Gabapentin in the Franklin v. Pfizer case. Concerns about the distorting effects of Pfizer's research practices upon the represented efficacy of Gabapentin have been summarized for the Prescription Access Litigation project in an August 10, 2008 article written by Kay Dickersin, M.D, Ph.D, a scholar of publication bias at Brown University.[22].

Despite this controversy, many psychiatrists continue to prescribe it for a variety of off-label purposes. It is often tried as an alternative treatment, when patients are unable to tolerate the side effect of more proven mood stabilizers such as lithium; as or more frequently, it is prescribed on a speculative basis as an auxiliary treatment, when single-drug therapy has consistently failed to yield sufficiently positive results.[23]

Precautions

Gabapentin should not be discontinued abruptly after long term use. Abrupt or over rapid withdrawal may provoke a withdrawal syndrome similar to alcohol or benzodiazepine withdrawal. Gradual reduction over a period of weeks or months helps minimize or prevents the withdrawal syndrome.[24]

Withdrawal

Although the potential for serious withdrawal symptoms are very limited as described in official literature, there is increasing awareness among users about existence and sheer frequency of potentially serious withdrawal symptoms even after long tapering.

Adverse effects

Gabapentin's most common side effects in adult patients include dizziness, drowsiness, and peripheral edema (swelling of extremities);[25] these mainly occur at higher doses, in the elderly. Also, children 3–12 years of age were observed to be susceptible to mild-to-moderate mood swings, hostility, concentration problems, and hyperactivity. Although rare, there are several cases of hepatotoxicity reported in the literature.[26] Gabapentin should be used carefully in patients with renal impairment due to possible accumulation and toxicity.[27][28]

An increase in formation of adenocarcinomas was observed in rats during preclinical trials, however the clinical significance of these results remains undetermined. Gabapentin is also known to induce pancreatic acinar cell carcinomas in rats through an unknown mechanism, perhaps by stimulation of DNA synthesis; these tumors did not affect the lifespan of the rats and did not metastasize.[29]

Recreational use

Although gabapentin is not a controlled substance, it does produce psychoactive effects that could lead to recreational use of the drug.[citation needed] However, it is widely regarded as having little or no potential for misuse. Pregabalin, a gabapentinoid with higher potency marketed for neuropathic pain, is a controlled substance, under Schedule V of the United States' Controlled Substances Act.

Risk of Suicide

The FDA has issued a warning of an increased risk of suicidal thoughts and behaviors in patients taking gabapentin. An independent analysis by the FDA showed that anticonvulsant drugs, including gabapentin, can increase suicidal thoughts in patients. The approved label for Neurontin now includes a warning about an increased risk of suicidal thoughts or actions and a guide to help patients understand this risk[30].

In July 2009, the first case against Pfizer, the maker of Neurontin, went to trial, and there are an estimated 1200 pending cases regarding the safety of Neurontin. Although a Pfizer spokesperson noted that "the reliable scientific evidence does not demonstrate a causal association between Neurontin treatment and suicidal behavior," the FDA analysis found an 80 percent rise in suicidal thoughts and behavior in data from 199 studies of gabapentin and other anticonvulsants[31].

Sales

Gabapentin is best known under the brand name Neurontin manufactured by Pfizer subsidiary Parke-Davis. A Pfizer subsidiary named Greenstone markets generic gabapentin.

In December 2004, the FDA granted final approval to a generic equivalent to Neurontin made by the Israeli firm Teva.

Neurontin is one of Pfizer’s best-selling drugs, and was one of the 50 most-prescribed drugs in the United States in 2003. However, in recent years, Pfizer has come under heavy criticism for its marketing of Neurontin, facing allegations that, behind the scenes, Parke-Davis marketed the drug for at least a dozen supposed uses for which the drug had not been FDA approved.

Franklin v. Pfizer case

Main article: David Franklin (scientist)

By some estimates, so-called off-label prescriptions account for roughly 90% of Neurontin sales.[32] While off-label prescriptions are common for a number of drugs and are perfectly legal (if not always appropriate), marketing of off-label uses of a drug is strictly illegal.[33] In 2004, Warner-Lambert agreed to plead guilty and pay $430 million in fines to settle civil and criminal charges regarding the illegal marketing of Neurontin for off-label purposes, and further legal action is pending. The courts of New York State, for example, have refused to certify a class of injured parties who took Neurontin for off-label use, finding that they had failed to state that they had any injury.[34]

The University of California, San Francisco (UCSF) has archived[35] and studied[36] the documents made public by this case, which opens a unique window into the illegal promotion and marketing of pharmaceuticals. However, Pfizer maintains that the illegal activity originated in 1996, well before it acquired Parke-Davis (through its acquisition of Warner-Lambert) in 2000. Several lawsuits are underway after people who had been prescribed gabapentin for off-label treatment of bipolar disorder later attempted or committed suicide.

Related drugs

Parke-Davis developed a drug called pregabalin to be a successor of gabapentin,[2] which was brought to market by Pfizer as Lyrica after they acquired Warner-Lambert. Pregabalin is related in structure to gabapentin and is approved for treatment of epilepsy, neuropathic pain associated with diabetes, fibromyalgia, post-herpetic neuralgia, and generalized anxiety disorder.

References

  1. ^ BNF (March 2003) 45
  2. ^ a b Baillie, J Kenneth; Ian Power (2006-01). "The mechanism of action of gabapentin in neuropathic pain". Current Opinion in Investigational Drugs (London, England: 2000) 7 (1): 33–9. ISSN 1472-4472. http://www.ncbi.nlm.nih.gov/pubmed/16425669. Retrieved 2009-03-25. 
  3. ^ Hendrich J, Van Minh AT, Heblich F, et al. (March 2008). "Pharmacological disruption of calcium channel trafficking by the alpha2delta ligand gabapentin". Proc. Natl. Acad. Sci. U.S.A. 105 (9): 3628–33. doi:10.1073/pnas.0708930105. PMID 18299583. PMC 2265195. http://www.pnas.org/cgi/pmidlookup?view=long&pmid=18299583. 
  4. ^ Davies et al. Functional biology of the alpha(2)delta subunits of voltage-gated calcium channels.Trends Pharmacol Sci. 2007 May;28(5):220-8.
  5. ^ Pfizer: Product Monograph NeurontinPDF (251 KB) Retrieved 14 August 2006
  6. ^ PROMETA Demonstrates Statisitcally Significant Reduction in Methamphetamine Cravings in Randomized Double-Blind Placebo Controlled Study
  7. ^ Add-on gabapentin in the treatment of opiate withdrawal
  8. ^ Gabapentin-Assisted Benzodiazepine Withdrawal In A Multidrug Dependent Patient
  9. ^ Mathew, NT; Rapoport A, Saper J, Magnus L, Klapper J,hello Ramadan N, Stacey B, Tepper S (2001). "Efficacy of gabapentin in migraine prophylaxis". Headache 41 (2): 119–28. doi:10.1046/j.1526-4610.2001.111006119.x. ISSN 0017-8748. PMID 11251695. 
  10. ^ Backonja, MM; Serra J (2004). "Pharmacologic management part 1: better-studied neuropathic pain diseases". Pain Med 5 (Suppl 1): S28–47. doi:10.1111/j.1526-4637.2004.04020.x. ISSN 1526-2375. PMID 14996228. 
  11. ^ Choudhuri, I; Sarvananthan N, Gottlob I (May 26, 2006). "Survey of management of acquired nystagmus in the United Kingdom". Eye 21 (9): 1194. doi:10.1038/sj.eye.6702434. ISSN 0950-222X. PMID 16732211. 
  12. ^ a b c Mack, Alicia (2003). "Examination of the evidence for off-label use of gabapentin" (PDF). Journal of Managed Care Pharmacy 9 (6): 559–68. PMID 14664664. http://www.amcp.org/data/jmcp/Contemporary%20Subject-559-568.pdf. Retrieved 2006-08-14. 
  13. ^ Gabapentin: pharmacology and its use in pain management; Rose, M., Kam, P.
  14. ^ Randomised controlled trial of gabapentin in Complex Regional Pain Syndrome type 1, Anton C van de Vusse , Suzanne GM Stomp-van den Berg , Alfons HF Kessels and Wim EJ Weber.
  15. ^ Chouinard, G (May 2006). "The search for new off-label indications for antidepressant, antianxiety, antipsychotic and anticonvulsant drugs". J Psychiatry Neurosci 31 (3): 168–176. ISSN 1180-4882. PMID 16699602. 
  16. ^ Frye, Mark A.; et al. (2000). "A Placebo-Controlled Study of Lamotrigine and Gabapentin Monotherapy in Refractory Mood Disorders" (Abstract). Journal of Clinical Psychopharmacology 20 (6): 607–14. doi:10.1097/00004714-200012000-00004. PMID 11106131. http://www.psychopharmacology.com/pt/re/jclnpsychopharm/abstract.00004714-200012000-00004.htm. Retrieved 2006-08-14. 
  17. ^ Guttuso, T Jr; Kurlan R; McDermott MP; Kieburtz K (February 2003). "Gabapentin's effects on hot flashes in postmenopausal women: a randomized controlled trial". Obstet Gynecol 101 (2): 337–45. doi:10.1016/S0029-7844(02)02712-6. PMID 12576259. 
  18. ^ Piccirillo, JF; Finnell J, Vlahiotis A, Chole RA, Spitznagel E (2007). "Relief of idiopathic subjective tinnitus: is gabapentin effective?". Arch Otolaryngol Head Neck Surg 133 (4): 390–7. doi:10.1001/archotol.133.4.390. PMID 17438255. 
  19. ^ Legros, B; Bazil, CW (January 2003). "Effects of antiepileptic drugs on sleep architecture: a pilot study.". Sleep Med. 4 (1): 51–5. doi:10.1016/s1389-9457(02)00217-4. PMID 14592360. 
  20. ^ Martínez-Raga, J; Sabater, A; Perez-Galvez, B; Castellano, M; Cervera, G (May 2004). "Add-on gabapentin in the treatment of opiate withdrawal". Progress in Neuro-Psychopharmacology and Biological Psychiatry 28 (3): 599–601. doi:10.1016/j.pnpbp.2003.11.020. PMID 15093968. 
  21. ^ Pande, AC; Crockatt JG, Janney CA, Werth JL, Tsaroucha G. (2000). "Gabapentin in bipolar disorder: a placebo-controlled trial of adjunctive therapy" (Abstract). Bipolar Disorders 2 (3 Pt 2): 249–55. doi:10.1034/j.1399-5618.2000.20305.x. PMID 11249802. 
  22. ^ Reporting and other biases in studies of Neurontin for migraine, psychiatric/bipolar disorders, nociceptive pain, and neuropathic pain [1]PDF (251 KB) Retrieved 28 March 2009
  23. ^ Baldessarini, Ross J.; Leahy L, Arcona S, Gause D, Zhang W, Hennen J. (2007). "Patterns of Psychotropic Drug Prescription for U.S. Patients With Diagnoses of Bipolar Disorders" (Abstract). Psychiatric Serv[ices] 58 (58): 85–91. doi:10.1176/appi.ps.58.1.85. 
  24. ^ Tran KT, Hranicky D, Lark T, Jacob Nj (June 2005). "Gabapentin withdrawal syndrome in the presence of a taper". Bipolar Disord 7 (3): 302–4. doi:10.1111/j.1399-5618.2005.00200.x. PMID 15898970. http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1398-5647&date=2005&volume=7&issue=3&spage=302. 
  25. ^ "FDA approved labeling for Neurontin capsules, tablets, and oral solution." (PDF). February 2005. http://www.fda.gov/cder/foi/label/2005/20235s029,20882s015,21129s016lbl.pdf. Retrieved 2008-12-30.  Note that an updated labeling has been approved, but is not available online as of November 2006
  26. ^ Maria C Lasso-de-la-Vega Pharm.D, MC; Zapater, P; Such, J; Pérez-Mateo, M; Horga, JF (2001). "Gabapentin-associated hepatotoxicity" (Abstract). Am J Gastroenterol 96 (12): 3460–3462. doi:10.1111/j.1572-0241.2001.05357.x/abs (inactive 2010-01-08). PMID 11774985. http://www.blackwell-synergy.com/links/doi/10.1111/j.1572-0241.2001.05357.x/abs. Retrieved 2007-02-14. 
  27. ^ Ayhan DOGUKAN, A; Aygen, B; Berilgen, MS; Dag, S; Bektas, S; Gunal, AI (2006). "Gabapentin-induced coma in a patient with renal failure" (Abstract). Hemodialysis International 10 (2): 168–169. doi:10.1111/j.1542-4758.2006.00089.x. PMID 16623669. http://www.blackwell-synergy.com/doi/abs/10.1111/j.1542-4758.2006.00089.x?journalCode=hdi. Retrieved 2007-02-14. 
  28. ^ Bookwalter T, Gitlin M, T; Gitlin, M (2005). "Gabapentin-induced neurologic toxicities" (Abstract). Pharmacotherapy 25 (12): 1817–9. doi:10.1592/phco.2005.25.12.1817. PMID 16305301. 
  29. ^ Gabapentin Official FDA information, side effects and uses
  30. ^ Suicidal Behavior and Ideation and Antiepileptic Drugs
  31. ^ Pfizer Faces First Trial on Neurontin Suicide Claim
  32. ^ "Huge penalty in drug fraud, Pfizer settles felony case in Neurontin off-label promotion.". San Francisco Chronicle. 2004-05-14. p. C-1. http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2004/05/14/BUGKK6L0LB1.DTL. 
  33. ^ Jane E. Henney, MD (15 August 2006). "Editorial: Safeguarding Patient Welfare: Who's In Charge?". Annals of Internal Medicine 145 (4): 305–307. PMID 16908923. http://www.annals.org/cgi/content/full/145/4/305?etoc. Retrieved 2006-08-14. 
  34. ^ Baron v. Pfizer, Inc., 2007 N.Y. Slip Op. 05813 (App. N.Y., July 5, 2007)
  35. ^ Drug Industry Document Archive
  36. ^ Narrative Review: The Promotion of Gabapentin: An Analysis of Internal Industry Documents - Steinman et al. 145 (4): 284 - Annals of Internal Medicine

External links

v • d • e
Analgesics (N02A, N02B)
Opioids
See also: Opioids template
Opium & alkaloids thereof
Semi-synthetic opium
derivatives
Synthetic opioids
Pyrazolones
Cannabinoids
Anilides
Non-steroidal
anti-inflammatories
See also: NSAIDs template
Propionic acid class
Oxicam class
Acetic acid class
Anthranilic acid
(fenamate) class
Atypical, adjunct and potentiators,
miscellaneous
v • d • e
Anticonvulsants (N03)
GABAA receptor agonist
Other GABA agents
Carbonic anhydrase inhibitor
Channel blockers
Primarily sodium
Primarily calcium
Unknown/ungrouped
Indirect GABA agents
Gabapentin · Pregabalin · Progabide · Vigabatrin
Unknown/multiple/
unsorted
#WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
v • d • e
Mood disorder: Bipolar disorder
History
Symptoms
Spectrum
Treatment
Non-pharmaceutical
Related

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

 
 

 

Copyrights:

Neurological Disorder. Gale Encyclopedia of Neurological Disorders. Copyright © 2005 by The Gale Group, Inc. All rights reserved.  Read more
Oncology Encyclopedia. Gale Encyclopedia of Cancer. Copyright © 2006 by The Gale Group, Inc. All rights reserved.  Read more
Dental Dictionary. Mosby's Dental Dictionary. Copyright © 2004 by Elsevier, Inc. All rights reserved.  Read more
Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
Wikipedia. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article "Gabapentin".  Read more