Gabapentin vs. Pregabalin for the Treatment of Neuropathic Pain in Patients with Spinal Cord Injury: A Crossover Study

Abstract

Objective: Neuropathic pain is a frequent complication of spinal cord injury. Almost 70% of patients with spinal cord injury (SCI) experience pain, and nearly one-third of these patients describe their pain as severe. Gabapentin and pregabalin are considered as first-line treatment for post-SCI neuropathic pain. However, there is no study comparing the effects of gabapentin and pregabalin in the management of neuropathic pain in patients with SCI. In this prospective, randomized, crossover clinical trial, we aimed to compare the efficacy of gabapentin and pregabalin in the treatment of neuropathic pain associated with SCI. Material and Methods: Thirty patients with spinal cord injury experiencing neuropathic pain were recruited for the study. Patients took medications for 8 weeks. After a 2-week washout period, medications were switched in a crossover design. The outcome measures for this study were visual analogue scale (VAS) for pain, VAS for sleep, Short Form Beck Depression Inventory, and the pain disability index. Results: Twenty-one patients completed the study. Seven patients who did not want to change their medication while they were using the first drug (4 patients were using gabapentin and 3 patients were using pregabalin) and 2 patients who experienced dizziness and nausea (both were in the pregabalin group) were dropped off. There was no difference between both drugs in terms of their efficacy for pain, anxiety, and sleep (p<0.05). Conclusion: There was no statistically significant difference between gabapentin and pregabalin in terms of study parameters for the treatment of neuropathic pain in patients with SCI.