Neuropathic pain is a specific type of painful sensation that develops as a consequence of damage to the Somatosensory system. This is a relatively complex state which tends to be chronic and seriously interfere with every day's activities. It develops as a result of some damage, dysfunction or an injury all of which may trigger incorrect signal release and transmission to pain centers in the body. The abnormal function of the nerves occurs at the very site of the injury and is also present in the nearby area.
Gabapentin - Drug for Neuropathic Pain
Neuropathic pain is definitely one of the most complex medical conditions and its treatment can be rater challenging. There is no unique drug that can efficiently deal with pain in all patients. Most of them need to take several drugs until they find the most efficient one.
The very condition may be associated with alcoholism, limb amputation, back/leg/hip problems and it also affects diabetics. Additionally, neuropathic pain affects certain number of patients who are suffering from cancer and have undergone chemotherapy. Furthermore, individuals with facial nerve problems, those suffering from HIV/AIDS, multiple sclerosis and shingles are all prone to this specific type of pain. Neuropathic pain is many times described as shouting or burning or may be in the form of tingling and numbness.
Gabapentin is one of several drugs doctors opt for when treating patients suffering from neuropathic pain. It is an analogue of GABA - gamma-amino butyric acid, which is in fact the chief inhibitory neurotransmitter of the central nervous system. The drug was initially used only in patients with epilepsy while later medical experts revealed that it can successfully deal with symptoms and signs of other diseases as well. Still, in spite of widespread usage in purpose of pain relief, scientist look further and investigate potential use of the drug in people suffering from migraines and bipolar disorder all of which might one day also benefit from this specifically designed medication.
How is Gabapentin Used?
It is confirmed that gabapentin provides pain relief in approximately one-third of all patients with fibromyalgia and those who face chronic neuropathic pain. What is more, it can manage pain experienced after surgical interventions and also help with neuropathic pain associated with cancer. Even HIV patients say that the drug may be highly efficient against their sensory neuropathy.
However, it seems that there is no difference when comparing the drug to carbamazepine, another epileptic drug commonly prescribed in individuals suffering from neuropathic pain. This is why additional research needs to be done. It might show which of the previously mentioned drugs posses better qualities and is superior when it comes to neuropathic pain relief.
As it is the case with any other drug, gabapentin has certain side effects. These include dizziness, drowsiness and swelling of the limbs (peripheral edema). Fortunately, these side effects affect only elderly patients and typically occur once the dose is exceeded. In small children the use of gabapentin may precipitate mood swings, make them become hostile and have concentration problems. They also might become hyperactive. In rather rare cases gabapentin may be toxic to the liver. This side effect is generally related to impaired function of the kidneys which instead of removing the drug form the body accumulate gabapentin and its excess then triggers liver damage.
Research on rats demonstrated that intake of gabapentin was associated with formation of adenocarcinoma in rats. Still, medical experts claim that plenty of additionally research needs to be performed to confirm whether this side effect may also affect humans. Apart from adenocarcinoma the drug seems to induce pancreatic acinar cells in tested animals.
Furthermore, gabapentin may increase the risk of suicide in susceptible individuals. It is additionally connected with the onset of depression and behavior abnormalities.
In case doctor decides that the drug should be discontinued, this process must take place gradually. Abrupt discontinuation may precipitate withdrawal syndrome that resembles withdrawal syndrome in alcoholics and people addicted to benzodiazepines. So, once the doctor decides that treatment with gabapentin should stop, the dose of the drug is slowly reduced and the complete process of discontinuation is supposed to last for weeks or even months. Sudden cessation may trigger headaches, palpitations, elevated blood pressure, chest pain and changes in behavior. Anxiety, agitation, restlessness and insomnia occur too.
Finally, sometimes intake of higher doses of gabapentin may result in toxicity. Drug overdose leads to drowsiness, blurred vision, slurred speech and somnolence. In severe cases patients end up in a coma. This is a medical emergency and by measuring serum concentrations of gabapentin doctors may easily confirm the excess of the drug, discontinue further administration and initiate treatment.
To sum up, gabapentin is one of several different drugs used in people suffering from neuropathic pain, a rather severe type of pain which is sometimes difficult to manage. Fortunately, this drug is efficient enough but may also cause certain side effects which are in general well tolerated. However, excess of gabapentin may cause damage to the body, be toxic to the liver or even cause lethal outcome.