Standard treatment of chronic neuropathy often fails to provide
adequate pain relief and may be associated with intolerable adverse
effects, especially in elderly patients. Backonja and colleaguesArticle
conducted a multicenter trial of gabapentin, an anticonvulsant, for the
treatment of painful diabetic neuropathy and Rowbotham and colleaguesArticle
conducted a similar trial for the treatment of postherpetic neuralgia.
In both studies, the researchers found that patients treated with
gabapentin had significant improvement in measures of pain
severity, sleep interference, and quality of life compared with those
who received placebo. Adverse effects associated with gabapentin
therapy included somnolence and dizziness. In a related editorial, Low
and DotsonArticle conclude that gabapentin may be the drug of first choice for
the treatment of postherpetic neuralgia and for some patients with
painful diabetic neuropathy.