Gabapentin for the treatment of cancer-related pain syndromes.

OBJECTIVES: Gabapentin was initially developed as an antiepileptic drug but was later discovered to be an effective treatment of neuropathic pain. Gabapentin has been successfully used for the treatment of multiple neuropathic pain syndromes such as diabetic neuropathy and postherpetic neuralgia. However, limited data exist about its efficacy for other pain syndromes. The objective of the current review is to describe, from the literature, the role of gabapentin for the treatment of cancer-related pain syndromes.
METHODS: Studies were identified by searching the PubMed electronic databases. Additional review articles and article reference lists were used to identify other studies.
RESULTS: Recent studies showed effectiveness of gabapentin in improving the pain control in patients with neuropathic cancer pain, already treated with opiates. Moreover, gabapentin appeared promising in reducing the need for high total doses of opioids and avoiding unplanned treatment interruptions for patients with head and neck malignancies treated with radiotherapy or concurrent chemoradiotherapy. Furthermore, the combination of gabapentin and morphine has been shown to effect better pain relief at lower doses of each drug when compared with gabapentin or morphine alone in patients with painful diabetic neuropathy or postherpetic neuralgia. The combination of both drugs was associated with a beneficial effect on pain-related interference with daily activity, mood, sleep and quality of life.
CONCLUSIONS: Given the significant benefits of gabapentin and the combination of gabapentin with opioids for the treatment of neuropathic pain, randomized clinical trials are needed to establish the role of these analgesic regimens for the treatment of neuropathic cancer pain.