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Gabapentin

Gabapentin was originally licensed for use as an anti-epileptic drug. It then became widely used in neuropathic pain, and has been proven to work as for migraine prevention.

Many severe headache disorders can be treated:

  1. Migraine (randomised trial 1998, but never published in full (to my knowledge), 145 subjects, dose 2400-3000mg/day)
  2. Chronic Daily Headache - 9% reduction in pain, randomised trial 2003, 133 subjects
  3. Cluster Headache (case series only, but 8 out of 8 resistant cases became pain free)
  4. SUNCT. Several case series. One series of 3 cases all responded. Another 10 did not. Not certain to say if effective.
  5. Trigeminal Neuralgia. Case series evidence only. Seemed to help at least one case of MS related neuralgia. NO randomised trials
  6. Supraorbital Neuralgia. Case report only.
  7. Glossopharyngeal neuralgia. Case series only. Recent series of 9 from Spain (article in Spanish, abstract in English 7/9 some response).
  8. Occipital Neuralgia Case report only.
  9. High Altitude Headache Case report only.
  10. Hypnic Headache case report evidence only
  11. Nummular Headache


References

Spira and Beran Prophylaxis of chronic daily headache. Neurology 2003;61:1753-1759. (Free Abstract only)

Mathew NT 1998 - presented to American Pain Society, California

Leandri M et al. Drug-resistant cluster headache: a pilot study Cephalalgia 2001;21:744-746 (Free Abstract only)

MC França Jr et al. Gabapentin-responsive idiopathic stabbing headache. Cephalalgia 2004;24:993-6 (Free Abstract only)

Cohen AS et al. Abnormal blink reflex studies in a patient with supraorbital neuralgia. Cephalalgia 2006;26:875-8. (Free Abstract only)

Moretti R et al. Glossopharyngeal neuralgia: a follow-up of four years of a single case.Eur J Pain. 2002;6:403-7. (Free Abstract only)

Frese A et al. Geniculate neuralgia as a manifestation of neuroborreliosis. Headache 2002;42:826-8(Free Abstract only) i.e. describes nervus intermedius pain treated with GBP.

Jafarian S et al. Low-dose-gabapentin in treatment of high-altitude headache. Cephalalgia 2007;27:1274-7 (Free Abstract only)

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