[Current data on gabapentin]

Abstract

Objective: To review the current data on gabapentin (GBP) with regard to its mechanism of action, pharmacokinetic characteristics, clinical efficacy, tolerance and mode of administration.

Development: GBP has a multiple mechanism of action which justifies its use in many clinical conditions besides epilepsy. These include neuropathic pain, psychiatric disorders, disorders of movement, and migraine. Its pharmacokinetic characteristics are nearly those of an ideal drug, with no interactions. Regarding clinical efficacy, there is much evidence of this in polytherapy and in monotherapy in adults and children with partial crises, with rare adverse effects and the exceptional possibility to establish the total dose of GBP in only a few days.

Conclusions: GBP is an effective drug in patients of all ages with partial crises. Because of its excellent tolerance and decreasing dose-dependent kinetics, conditioned by less absorption of the drug, we recommend the administration of GBP at doses higher than those normally used. Thus we suggest a dose of 900 to 2,400 mg/day in patients with a new diagnosis, of 1,800 to 3,600 mg/day as a second therapeutic alternative and even 2,400 to 4,800 mg/day when other antiepileptic drugs have failed to be of use.