[Titration and dosage of gabapentin]

Gabapentin (GBP) is a new anti epileptic drug which is indicated in partial epilepsy as either monotherapy or additional therapy. Unlike most anti epileptic drugs, GBP can be rapidly titrated.

A recent double blind trial has shown that treatment with GBP may start with 900mg from the first day (300 mg every 8 hours). This dose is sufficient to be effective as monotherapy in patients with partial epilepsy of recent onset. It is also known that in patients with drug resistant epilepsy high doses of anti epileptic drugs are often necessary. In the clinical trials carried out before gabapentin was put on the market, the doses used were generally low (almost always below 1,800 mg/day). However, recent experience has shown that doses of up to 4,800 mg/day markedly increase the efficacy without significant increase in the rate of adverse effects.

Recent data suggest that GBP may be rapidly titrated and high doses of GBP show greater efficacy with no increase in adverse effects, so they are advisable in drug resistant patients.