Comparison of the efficacy of gabapentin and pregabalin for neuropathic pain in patients with spinal cord injury: A crossover study

Objectives: To compare the efficacy and side effects of gabapentin and pregabalin for the treatment of neuropathic pain(NP) in spinal cord injury (SCI). Methods: Twenty eight patients were included in the study. The patients were randomized to receive pregabalin or gabapentin. VAS(Visual analog scale) pain score, neuropathic pain scale(NPS), Lattinen test(LT), Beck Depression Inventory(BDI) pain diary measures were used for the patient evaluation. We assessed patients at 4th and 8th weeks. Treatment groups were crossed over after 2 weeks of wash-out period to receive the other treatment. Results: At the end of the study there was significant improvement in VAS both with gabapentin and pregabalin (p<0.001). Statistically significant difference was present during the first 4 weeks in the assessment with VAS as for pregabalin group compared to gabapentin group(p<0.05). But after 8 weeks of treatments the significance disappeared between the pregabalin and the gabapentin groups (p>0.05). In NPS, and LT parameters, no difference was present between the two study groups before or after the treatment (p>0.05). In both groups no significant improvement was seen in emotional status as assessed with BDI (p>0.05). Frequency of side effects and exclusion from the study due to side effects were higher for the pregabalin group but it was not significant between the groups (p>0.05). Conclusions: It is concluded that both drugs are effective and safe for the treatment of NP due to SCI but no difference exist between the two drugs. We are in the opinion that large studies that include more patients and placebo control should be carried out for more accurate data about this topic.