A drug used to prevent seizures can improve pain relief for some people taking opioids for cancer pain, European researchers report.
There have been anecdotal reports that the new-generation anti-convulsant Neurontin (gabapentin) is effective when used in combination with opioid painkillers, Dr. Augusto Caraceni of the National Cancer Institute of Milan, Italy and colleagues note in the Journal of Clinical Oncology.
To investigate further, the researchers studied 121 patients with nerve-type cancer pain, which was partially relieved with opioid drugs. While remaining on their opioid medication, the participants were randomly assigned to additional treatment with Neurontin or an inactive placebo. Extra opioid doses were supplied as needed.
Overall, 89 patients completed the ten-day study. Average pain scores on a 10-point scale were significantly different between patients taking Neurontin (4.6) and those given the placebo (5.4).
Moreover, use of supplementary opioid doses was higher and more frequent among placebo patients.
The researchers conclude that the findings “demonstrate a limited role of gabapentin as adjuvant to opioids for neuropathic cancer pain.” Nevertheless, they add, “Significant benefit could be seen in some patients.”
SOURCE: Journal of Clinical Oncology, June 15, 2004.
Revision date: July 7, 2011
Last revised: by David A. Scott, M.D.