gabapentin

acute bipolar disorder symptom rating scales (MMPI-2, CGI-BP, YMRS, HAM-D)

Each study assessed the efficacy of gabapentin using a different outcome measure. Quantitative analysis was not performed due to clinical and methodological heterogeneity.

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all-cause drop-out, gabapentin in insomnia trials

no effect, RR 0.96, 95% CI 0.59-1.57, n = 171

The RR for all-cause drop-out was comparable for gabapentin and placebo (RR 0.96, 95% CI 0.59–1.57) (Supplementary Appendix, Fig. 25).

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all-cause drop-out, insomnia trials

no effect, (RR 0.96, 95% CI 0.59–1.57)

The RR for all-cause drop-out was comparable for gabapentin and placebo (RR 0.96, 95% CI 0.59–1.57) (Supplementary Appendix, Fig. 25).

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Clinical Global Impressions-Bipolar Version (CGI-BP) change score, 1-year long-term remitted bipolar disorder

decreases, (gabapentin -2.1, placebo -0.6), n = 25

There was a significant difference in favor of gabapentin in baseline-to-endpoint (1 year) change in CGI-BP score (gabapentin -2.1, placebo -0.6) and in use of sleeping medication (PSQI-item 6, gabapentin -1.1 vs. placebo -0.6).

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Clinical Global Impressions-Bipolar Version (CGI-BP) change score at 1 year, gabapentin vs placebo, long-term remitted bipolar disorder

decreases, (gabapentin -2.1, placebo -0.6), n = 25

Not recorded as a finding: no CAT:outcome node exists for a bipolar-disorder global-impression severity score

There was a significant difference in favor of gabapentin in baseline-to-endpoint (1 year) change in CGI-BP score (gabapentin -2.1, placebo -0.6) and in use of sleeping medication (PSQI-item 6, gabapentin -1.1 vs. placebo -0.6).

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clinician-rated global bipolar disorder severity (CGI-BP), long-term maintenance treatment

decreases, gabapentin -2.1 vs placebo -0.6 on CGI-BP change score at 1 year, n = 25

Not recorded as a finding: no outcome node for CGI-BP exists in the vocabulary

There was a significant difference in favor of gabapentin in baseline-to-endpoint (1 year) change in CGI-BP score (gabapentin -2.1, placebo -0.6) and in use of sleeping medication (PSQI-item 6, gabapentin -1.1 vs. placebo -0.6).

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long-term bipolar disorder severity (CGI-BP)

decreases, gabapentin -2.1 vs placebo -0.6 at 1 year, n = 25

There was a significant difference in favor of gabapentin in baseline-to-endpoint (1 year) change in CGI-BP score (gabapentin -2.1, placebo -0.6) and in use of sleeping medication (PSQI-item 6, gabapentin -1.1 vs. placebo -0.6).

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manic/depressive symptom rating scales (MMPI-2, YMRS, HAM-D, CGI-BP), acute bipolar disorder

Quantitative analysis was not performed due to clinical and methodological heterogeneity.

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manic symptom severity (YMRS), acute adjunctive treatment of bipolar disorder

placebo group showed significantly greater YMRS improvement than gabapentin (adjunctive to valproate/lithium)

Not recorded as a finding: no outcome node for YMRS exists in the vocabulary; not pooled due to heterogeneity

The placebo group showed a significantly greater improvement in the total YMRS change score compared to gabapentin.

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Panic and Agoraphobia Scale change score, gabapentin vs placebo, panic disorder, 8 weeks

no effect

Not recorded as a finding: no CAT:outcome node exists for the Panic and Agoraphobia Scale, and the finding is a single small trial with no pooled estimate

However, eight weeks of flexibly dosed gabapentin was not more effective than placebo in patients with PD (comparable baseline-to-endpoint change on the Panic and Agoraphobia Scale).

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Panic and Agoraphobia Scale change score, panic disorder, 8 weeks

no effect

However, eight weeks of flexibly dosed gabapentin was not more effective than placebo in patients with PD (comparable baseline-to-endpoint change on the Panic and Agoraphobia Scale).

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panic disorder symptom severity (Panic and Agoraphobia Scale), gabapentin versus placebo

no effect, comparable baseline-to-endpoint change between arms

Not recorded as a finding: no outcome node for the Panic and Agoraphobia Scale exists in the vocabulary

However, eight weeks of flexibly dosed gabapentin was not more effective than placebo in patients with PD (comparable baseline-to-endpoint change on the Panic and Agoraphobia Scale).

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panic disorder symptoms (Panic and Agoraphobia Scale)

no effect, comparable baseline-to-endpoint change

However, eight weeks of flexibly dosed gabapentin was not more effective than placebo in patients with PD (comparable baseline-to-endpoint change on the Panic and Agoraphobia Scale).

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preoperative anxiety, dose-stratified subgroup (gabapentin >600 mg versus placebo)

decreases, high dose (>600 mg): SMD -1.30, 95% CI -1.72 to -0.87 (significant); low dose (≤600 mg): not significant

Not recorded as a finding: subgroup of the overall preoperative-anxiety pooled estimate already claimed against CAT:outcome/anxiety-symptom-severity-pooled; recording the dose stratum separately would report a subgroup as the whole-population finding

High doses (>600 mg) of gabapentin were found to be significantly effective in reducing preoperative anxiety (SMD -1.30, 95% CI -1.72 to -0.87), but low doses (600 mg) were not.

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preoperative anxiety (pooled across scales)

decreases, SMD -0.92, 95% CI -1.32 to -0.52

Compared with placebo, both pregabalin (SMD -0.55, 95% CI -0.92 to -0.18) and gabapentin (SMD -0.92, 95% CI -1.32 to -0.52) were significantly more effective in reducing preoperative anxiety.

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preoperative anxiety, pooled standardised mean difference across unnamed instruments

decreases, (SMD -0.92, 95% CI -1.32 to -0.52)

Compared with placebo, both pregabalin (SMD -0.55, 95% CI -0.92 to -0.18) and gabapentin (SMD -0.92, 95% CI -1.32 to -0.52) were significantly more effective in reducing preoperative anxiety.

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sleep scale improvement in alcohol-dependence-related sleep disturbance, gabapentin versus placebo

Not recorded as a finding: sentence names 'sleep scales' generically rather than the instrument (PSG/actigraphy/diary) required by the sleep-onset-latency/total-sleep-time nodes, and is a one-sided negation ('did not demonstrate improvement'), not a two-sided no_effect statement

In participants with alcohol dependence and related sleep disturbance, gabapentin did not demonstrate improvement in sleep scales compared to placebo (Supplementary Appendix, Figs. 12 and 13).

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sleep scale scores, alcohol dependence and related sleep disturbance

In participants with alcohol dependence and related sleep disturbance, gabapentin did not demonstrate improvement in sleep scales compared to placebo (Supplementary Appendix, Figs. 12 and 13).

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sleep scale scores in alcohol dependence and related sleep disturbance, gabapentin vs placebo, 2-trial random-effects meta-analysis

Not recorded as a finding: one-sided negation ('did not demonstrate improvement') without a two-sided no_effect statement in the same sentence, and no specific sleep instrument is named

In participants with alcohol dependence and related sleep disturbance, gabapentin did not demonstrate improvement in sleep scales compared to placebo (Supplementary Appendix, Figs. 12 and 13).

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sleep scales in alcohol-dependence-related sleep disturbance

n = 171

In participants with alcohol dependence and related sleep disturbance, gabapentin did not demonstrate improvement in sleep scales compared to placebo (Supplementary Appendix, Figs. 12 and 13).

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social anxiety disorder symptom scales, long-term gabapentin

decreases

A 14-week study of gabapentin in SAD showed significant improvement in symptoms compared to placebo across multiple clinician-evaluated and self-report rating scales.

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social anxiety disorder symptom severity, long-term gabapentin treatment, multiple clinician-evaluated and self-report scales

decreases

Not recorded as a finding: no single named instrument; not pooled

A 14-week study of gabapentin in SAD showed significant improvement in symptoms compared to placebo across multiple clinician-evaluated and self-report rating scales.

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clinical global impression of change at 8 weeks

no effect, SMD 0.07, 95% CI -0.20 to 0.35, P=0.6, p = 0.6

According to the result, the experimental group showed a slightly better clinical global impression of change compared with the control group (SMD = 0.07, 95% CI: −0.20–0.35, P = 0.6).

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clinical global impression of change at 8 weeks, 2 studies

no effect, (SMD = 0.07, 95% CI: −0.20–0.35), p = 0.6

According to the result, the experimental group showed a slightly better clinical global impression of change compared with the control group (SMD = 0.07, 95% CI: −0.20–0.35, P = 0.6).

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incidence of adverse reactions

decreases, RR 0.59, 95% CI 0.45-0.79, P=0.0003 (favoring duloxetine, i.e. fewer adverse reactions than gabapentin), p = 0.0003, n = 538

The meta-analysis result of the six studies showed a lower incidence of adverse reactions in the experimental group compared with the control group (RR = 0.59, 95% CI: 0.45–0.79, P = 0.0003).

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incidence of adverse reactions, 6 studies

decreases, (RR = 0.59, 95% CI: 0.45–0.79), p = 0.0003, n = 538

The meta-analysis result of the six studies showed a lower incidence of adverse reactions in the experimental group compared with the control group (RR = 0.59, 95% CI: 0.45–0.79, P = 0.0003).

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response rate at week 2, 3 studies

no effect, (RR = 1.05, 95% CI: 0.92–1.20), p = 0.47, n = 234

The analysis results showed that the response rate in the control group was slightly higher than that in the control group (RR = 1.05, 95% CI: 0.92–1.20, P = 0.47).

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sleep interference score at 8 weeks

decreases, SMD -0.35, 95% CI -0.63 to -0.08, P=0.01 (favoring duloxetine over gabapentin), p = 0.01

The results showed that the sleep interference score at 8 weeks in the experimental group was lower than that of the control group (SMD = -0.35, 95% CI: −0.63 to −0.08, P = 0.01).

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sleep interference score at 8 weeks, 2 studies

decreases, (SMD = -0.35, 95% CI: −0.63 to −0.08), p = 0.01

The results showed that the sleep interference score at 8 weeks in the experimental group was lower than that of the control group (SMD = -0.35, 95% CI: −0.63 to −0.08, P = 0.01).

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treatment response rate

no effect, RR 1.05, 95% CI 0.92-1.20, P=0.47, p = 0.47, n = 234

The analysis results showed that the response rate in the control group was slightly higher than that in the control group (RR = 1.05, 95% CI: 0.92–1.20, P = 0.47).

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VAS pain score, all 7 studies

no effect, (SMD = −0.26, 95% CI: −0.53–0.002), p = 0.07, n = 624

The analysis results showed (SMD = −0.26, 95% CI: −0.53–0.002), P = 0.07) a slightly better outcome in the experimental group compared with the control group.

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feeding tube (PEG) placement during chemoradiotherapy

no effect, p = 0.962

The pooled risk difference suggests there is no evidence for difference between the groups (RD = 0.64%, 95%CI: (− 25.8%, 27.1%), p = 0.962).

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pain severity during chemoradiation, multiple unpooled patient-reported instruments (Likert, VAS, EORTC pain scale, Vanderbilt survey)

Due to the variety of instruments selected by the investigators in these studies to quantify pain, it would be difficult to perform a meaningful meta-analysis of this data.

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reactive feeding-tube (PEG) placement, pooled risk difference

no effect, (RD = 0.64%, 95%CI: (− 25.8%, 27.1%), p = 0.962), p = 0.962

The pooled risk difference suggests there is no evidence for difference between the groups (RD = 0.64%, 95%CI: (− 25.8%, 27.1%), p = 0.962).

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reactive feeding tube placement rate during head and neck cancer chemoradiation, pooled risk difference between prophylactic gabapentin and control

no effect, (RD = 0.64%, 95%CI: (− 25.8%, 27.1%), p = 0.962), p = 0.962

Not recorded as a finding: this platform holds no node for the endpoint

The pooled risk difference suggests there is no evidence for difference between the groups (RD = 0.64%, 95%CI: (− 25.8%, 27.1%), p = 0.962).

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postoperative nausea

no effect, n = 1388

According to the head-to-head comparisons (eFigure 3C in Supplement 1), there is no significant difference between all different dosages of gabapentin and pregabalin.

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postoperative nausea after spine surgery

no effect, n = 1388

Not recorded as a finding: no outcome node for nausea exists in the vocabulary

According to the head-to-head comparisons (eFigure 3C in Supplement 1), there is no significant difference between all different dosages of gabapentin and pregabalin.

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postoperative opioid consumption

decreases, n = 1070

According to the head-to-head comparisons (eFigure 3B in Supplement 1), all different dosages of gabapentin and pregabalin have lower opioid consumption than placebo except for gabapentin 300 mg and 800 mg and pregabalin 75 mg.

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postoperative opioid consumption (morphine milligram equivalents) after spine surgery

decreases, n = 1070

Not recorded as a finding: no outcome node for opioid consumption exists in the vocabulary

According to the head-to-head comparisons (eFigure 3B in Supplement 1), all different dosages of gabapentin and pregabalin have lower opioid consumption than placebo except for gabapentin 300 mg and 800 mg and pregabalin 75 mg.

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postoperative parenteral opioid consumption, network SUCRA ranking

decreases, (SUCRA, 91.0%; mean difference, −22.07%; 95% CI, −33.22% to −10.92%)

According to SUCRA probability (Table 2), gabapentin 900 mg (SUCRA, 91.0%; mean difference, −22.07%; 95% CI, −33.22% to −10.92%) was most likely to be ranked the best.

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postoperative VAS pain score

decreases, n = 1427

According to the head-to-head comparisons (eFigure 3A in Supplement 1), all different dosages of gabapentin and pregabalin have lower VAS scores than placebo except for gabapentin 400 mg, 800 mg, and pregabalin 75 mg.

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postoperative Visual Analog Scale (VAS) pain score, network SUCRA ranking

decreases, (SUCRA, 90.8%; mean difference, −2.67%; 95% CI, −3.80% to −1.54%)

According to SUCRA probability (Table 2), gabapentin 900 mg (SUCRA, 90.8%; mean difference, −2.67%; 95% CI, −3.80% to −1.54%) was most likely to be ranked the best.

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anxiety score

decreases, MD -1.32, 95% CI -1.53 to -1.11, P<.00001

gabapentin supplementation could significantly decrease anxiety score compared to control intervention (moderate quality, MD = −1.32; 95% CI = −1.53 to −1.11; P <.00001; Fig. 7).

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anxiety score compared to control intervention, instrument not named

decreases, (MD = −1.32; 95% CI = −1.53 to −1.11)

In addition, gabapentin supplementation could significantly decrease anxiety score compared to control intervention (moderate quality, MD = −1.32; 95% CI = −1.53 to −1.11; P <.00001; Fig. 7).

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incidence of postoperative nausea

no effect, OR 0.51, 95% CI 0.15-1.73, P=.28, p = 0.28

but showed no influence on nausea (very low quality, OR = 0.51; 95% CI = 0.15–1.73; P =.28; Fig. 9).

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pain score at 24 hours postoperative

decreases, MD -0.70, 95% CI -0.86 to -0.55, P<.00001

resulted in substantially reduced pain scores at 24 hours (high quality, MD = −0.70; 95% CI = −0.86 to −0.55; P <.00001; Fig. 6).

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postoperative bradycardia

no effect, RR 1.00, 95% CI 0.21-4.81, n = 268

Bradycardia: There were 2 studies including 268 patients reporting the prevention of postoperative bradycardia without statistically significant difference (RR 1.00, 95% CI 0.21–4.81) between patients using gabapentin and placebo (Table 2).

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postoperative bradycardia incidence

no effect, (RR 1.00, 95% CI 0.21–4.81), n = 268

Bradycardia: There were 2 studies including 268 patients reporting the prevention of postoperative bradycardia without statistically significant difference (RR 1.00, 95% CI 0.21–4.81) between patients using gabapentin and placebo (Table 2).

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postoperative dizziness

no effect, RR 1.50, 95% CI 0.61-3.69, n = 146

There were 2 studies including 146 patients reporting incidence of postoperative dizziness, compared with placebo, which was estimated without statistical reduction (RR 1.50, 95% CI 0.61–3.69; Table 2).

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postoperative dizziness incidence

(RR 1.50, 95% CI 0.61–3.69), n = 146

Dizziness: There were 2 studies including 146 patients reporting incidence of postoperative dizziness, compared with placebo, which was estimated without statistical reduction (RR 1.50, 95% CI 0.61–3.69; Table 2).

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postoperative headache

no effect, RR 1.14, 95% CI 0.58-2.24, n = 236

Headache was involved in 3 studies including 236 patients, there was no statistical significance of reduction in this side effect (RR 1.14, 95% CI 0.58–2.24) between patients taking gabapentin orally and who got placebo (Table 2).

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postoperative headache incidence

(RR 1.14, 95% CI 0.58–2.24), n = 236

Headache: Headache was involved in 3 studies including 236 patients, there was no statistical significance of reduction in this side effect (RR 1.14, 95% CI 0.58–2.24) between patients taking gabapentin orally and who got placebo (Table 2).

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postoperative hypotension

RR 0.87, 95% CI 0.31-2.40, n = 268

Hypotensive was involved in 2 studies including 268 patients, compared with placebo, the pooled estimate did not exclude a statistical reduction in hypotensive (RR 0.87, 95% CI 0.31–2.40) in patients receiving gabapentin (Table 2).

PMID:40068032 · one of two readings recorded this

postoperative hypotension incidence

(RR 0.87, 95% CI 0.31–2.40), n = 268

Hypotensive: Hypotensive was involved in 2 studies including 268 patients, compared with placebo, the pooled estimate did not exclude a statistical reduction in hypotensive (RR 0.87, 95% CI 0.31–2.40) in patients receiving gabapentin (Table 2).

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postoperative nausea (PON)

RR 0.75, 95% CI 0.38-1.41, n = 490

Compared with placebo, a probable reduction in PON without statistical significance (RR 0.75, 95% CI 0.38–1.41) was exposed in patients receiving gabapentin (Table 2).

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postoperative nausea (PON) incidence

decreases, (RR 0.75, 95% CI 0.38–1.41)

Compared with placebo, a probable reduction in PON without statistical significance (RR 0.75, 95% CI 0.38–1.41) was exposed in patients receiving gabapentin (Table 2).

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postoperative pruritus

n = 304

Pruritus: 3 studies including 304 patients assessed postoperative pruritus.

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postoperative pruritus incidence

(RR 0.76, 95% CI 0.40–1.46), n = 304

Pruritus: 3 studies including 304 patients assessed postoperative pruritus. The pooled analysis did not show a statistically significant decrease, while with a reduced trend in this side effect (RR 0.76, 95% CI 0.40–1.46) in gabapentin group (Table 2).

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postoperative shivering

decreases, pooled RR 0.38, 95% CI 0.25-0.57, n = 544

Postoperative shivering (pooled RR 0.38, 95% CI 0.25–0.57) in the controlled group using placebo was more obvious than the study group adopting gabapentin.

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postoperative shivering, 5-point shivering severity score (0 = none to 4 = shivering all over the body)

decreases, (pooled RR 0.38, 95% CI 0.25–0.57)

Not recorded as a finding: this platform holds no node for the endpoint

Postoperative shivering (pooled RR 0.38, 95% CI 0.25–0.57) in the controlled group using placebo was more obvious than the study group adopting gabapentin.

PMID:40068032 · one of two readings recorded this

postoperative shivering, graded on a 5-point shivering scale, pooled risk ratio across 6 RCTs

decreases, pooled RR 0.38, 95% CI 0.25-0.57, n = 544

Not recorded as a finding: this platform holds no node for the endpoint

Postoperative shivering (pooled RR 0.38, 95% CI 0.25–0.57) in the controlled group using placebo was more obvious than the study group adopting gabapentin.

PMID:40068032 · one of two readings recorded this

postoperative shivering incidence, 5-point shivering grade

decreases, (pooled RR 0.38, 95% CI 0.25–0.57)

Postoperative shivering (pooled RR 0.38, 95% CI 0.25–0.57) in the controlled group using placebo was more obvious than the study group adopting gabapentin.

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postoperative urine retention

RR 0.50, 95% CI 0.24-1.03, n = 136

2 studies including 136 patients assessed urine retention after surgery, and the pooled estimate almost showed the significant reduction of postoperative urine retention (RR 0.50, 95% CI 0.24–1.03) in patients who took gabapentin orally (Table 2).

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postoperative urine retention incidence

decreases, (RR 0.50, 95% CI 0.24–1.03), n = 136

Urine retention: 2 studies including 136 patients assessed urine retention after surgery, and the pooled estimate almost showed the significant reduction of postoperative urine retention (RR 0.50, 95% CI 0.24–1.03) in patients who took gabapentin orally (Table 2).

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postoperative vomiting (POV)

decreases, RR 0.35, 95% CI 0.16-0.77, n = 136

POV was involved in 2 studies including 136 patients, the pooled estimate showed a statistical reduction in POV (RR 0.35, 95% CI 0.16–0.77) in patients who got gabapentin instead of placebo (Table 2).

PMID:40068032 · one of two readings recorded this

postoperative vomiting (POV) incidence

decreases, (RR 0.35, 95% CI 0.16–0.77), n = 136

Postoperative vomiting (POV): POV was involved in 2 studies including 136 patients, the pooled estimate showed a statistical reduction in POV (RR 0.35, 95% CI 0.16–0.77) in patients who got gabapentin instead of placebo (Table 2).

PMID:40068032 · one of two readings recorded this