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Gabapentin monotherapy for epilepsy: A review
Liliya Eugenevna Ziganshina1,2,3, Tatyana Abakumova4, Charles H V Hoyle5
1Centre for Knowledge Translation, Federal State Budgetary Educational Institution of Continuing Professional Education "Russian Medical Academy of Continuing Professional Education", The Ministry of Health of the Russian Federation (RMANPO), Moscow, Russian Federation.
Gabapentin monotherapy for focal epilepsy showed similar seizure control to other antiepileptic drugs. However, it led to more overall treatment withdrawals but fewer adverse event withdrawals compared to some alternatives.
Area of Science:
- Neurology
- Pharmacology
Background:
- Epilepsy is a common chronic neurological disorder affecting over 50 million people worldwide.
- This review focuses on gabapentin as monotherapy for focal epilepsy, including newly diagnosed and drug-resistant cases.
Approach:
- Systematic review of five randomized controlled trials involving 3167 participants.
- Searched multiple databases including Cochrane Register of Studies and MEDLINE up to February 2020.
- Assessed trial quality, risk of bias, and used GRADE to evaluate evidence certainty, which was very low to moderate.
Key Points:
- Gabapentin monotherapy demonstrated comparable seizure control to comparator antiepileptic drugs (AEDs) like lamotrigine, carbamazepine, oxcarbazepine, and topiramate.
- Participants on gabapentin were more likely to withdraw for any reason compared to those on lamotrigine, oxcarbazepine, or topiramate.
- Fewer participants withdrew due to adverse events with gabapentin compared to carbamazepine, oxcarbazepine, or topiramate.
Conclusions:
- Gabapentin monotherapy's efficacy in controlling focal epilepsy seizures is likely similar to other AEDs.
- Gabapentin may offer benefits in patient retention and reducing adverse event-related withdrawals compared to carbamazepine.
- Common side effects of gabapentin include ataxia, dizziness, fatigue, and drowsiness.
