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J Neurol Neurosurg Psychiatry 66:251-252 doi:10.1136/jnnp.66.2.251
  • Letters to the editor

Gabapentin in the treatment of painful diabetic neuropathy: a placebo controlled, double blind, crossover trial

  1. KENNETH C GORSON,
  2. CECILIA SCHOTT,
  3. ROBERT HERMAN,
  4. ALLAN H ROPPER
  1. Neurology Service, St. Elizabeth’s Medical Center
  2. Department of Family Medicine and Community Health, New England Medical Cente, Tufts University School of Medicine, Boston, MA, USA
  1. Dr Kenneth C Gorson, Division of Neurology, St Elizabeth’s Medical Center, 736 Cambridge Street, Boston, MA 02135, USA. Telephone 001 617 789 2375; fax 001 617 789 5177.
  1. WILLIAM M RAND
  1. Neurology Service, St. Elizabeth’s Medical Center
  2. Department of Family Medicine and Community Health, New England Medical Cente, Tufts University School of Medicine, Boston, MA, USA
  1. Dr Kenneth C Gorson, Division of Neurology, St Elizabeth’s Medical Center, 736 Cambridge Street, Boston, MA 02135, USA. Telephone 001 617 789 2375; fax 001 617 789 5177.

    Painful neuropathy is a common and disabling problem in patients with longstanding diabetes mellitus. Tricyclic antidepressant drugs and other chronic analgesics have been beneficial in some patients,1 but no agent successfully relieves pain in most patients and adverse effects often preclude their use in high doses. Anecdotal reports suggest that gabapentin ameliorates pain associated with neuropathy and other neurological conditions with few side effects.2 3 We conducted a randomised, double blind, placebo controlled trial to study the effect of low dose gabapentin in patients with painful diabetic neuropathy.

    We recruited 40 patients with painful diabetic neuropathy who had (1) diabetes for at least 6 months on a stable dosage of insulin or oral hypoglycaemic agent, (2) distal symmetric sensorimotor neuropathy as shown by impaired pin prick, temperature, or vibration sensation in both feet and absent or reduced ankle reflexes, and (3) daily neuropathic pain in the acral extremities, of at least moderate severity, for over 3 months that interfered with daily activity or sleep. Excluded were those with diabetes and chronic renal insufficiency, painful diabetic plexopathy, or lumbosacral polyradiculopathy, peripheral vascular disease, another painful condition, or other cause for neuropathy. Patients were randomly assigned to gabapentin (300 mg capsules) or placebo for 6 weeks (phase …