Clinical Rheumatology

, Volume 26, Issue 4, pp 561–565 | Cite as

The effect of gabapentin in earlier stage of reflex sympathetic dystrophy

  • Arif Kenan Tan
  • Iltekin DumanEmail author
  • Mehmet Ali Taşkaynatan
  • Bülent Hazneci
  • Tunc Alp Kalyon
Original article


The objective of this paper is to investigate the effect of gabapentin in the earlier stage of reflex sympathetic dystrophy syndrome (RSD). Twenty-two patients diagnosed with RSD were enrolled. Initial gabapentin dosage was 600 mg/day. This dosage is increased gradually until a satisfactory pain level was reached. After this level, this dosage was maintained throughout the study. An exercise program was also applied to the patients. Provoked and static pain scores of the patients were obtained initially, at 3-day intervals for maintenance dosage determining, and at 6 weeks after the discharge. Functional improvement parameters were volumetric measurement; dynamometric measurement and third finger pulp-distal palmar crease distance measurement for hands; and metric circumferential measurement and range of motion for elbow, knee, and foot initially, at baseline, on the tenth day, upon discharge, and 6 weeks after the discharge. The mean maintenance dose of gabapentin was 1,145.46±377.6 mg/day (range, 900–1,800 mg/day). Improvements in spontaneous and provoked pain intensities were statistically significant. No statistically significant difference was obtained in functional improvement parameters. Dizziness in three patients, headache in two patients, and mild burning feeling in the tongue in one patient were the reported side effects. These symptoms resolved spontaneously in few days. Gabapentin cannot be recommended as the drug of choice, but it may be considered as one of the therapeutic alternatives in the management of pain due to RSD. We suggest that it is effective only for the pain and not for other symptoms of RSD. Serious side effects that will cause the patient to stop using the drug are rare.


Complex regional pain syndrome Gabapentin Neuropathic pain Reflex sympathetic dystrophy 


  1. 1.
    van de Vusse Anton C et al (2004) Randomized controlled trial of gabapentin in complex regional pain syndrome type I. BMC Neurol 4:13PubMedCrossRefGoogle Scholar
  2. 2.
    Mellick GA, Mellick LB (1997) Reflex sympathetic dystrophy treated with gabapentin. Arch Phys Med Rehabil 78:98–105PubMedCrossRefGoogle Scholar
  3. 3.
    Navani A, Rusy LM, Jacobson RD, Weisman SJ (2003) Treatment of tremors in complex regional pain syndrome. J Pain Symptom Manage 25(4):386–390PubMedCrossRefGoogle Scholar
  4. 4.
    Mellick GA, Mellick LB (1995) Successful treatment of reflex sympathetic dystrophy with gabapentin. Am J Emerg Med 13:96PubMedCrossRefGoogle Scholar
  5. 5.
    Epstein B, Childers MK (1998) The use of gabapentin for neuropathic and musculoskeletal pain: a case series. J Neurol Rehabil 12(2):81–85Google Scholar
  6. 6.
    Wheeler DS, Vaux KK, Tam DA (2000) Use of gabapentin in the treatment of childhood reflex sympathetic dystrophy. Pediatr Neurol 22:220–221PubMedCrossRefGoogle Scholar
  7. 7.
    Maneksha FR, Mirza H, Poppers PJ (2000) Complex regional pain syndrome with resistance to local anesthetic block: a case report. J Clin Anesth 12:67–71PubMedCrossRefGoogle Scholar
  8. 8.
    Mellick GA, Mellick LB (1995) Gabapentin in the management of reflex sympathetic dystrophy. J Pain Symptom Manage 10(4):265–266PubMedCrossRefGoogle Scholar
  9. 9.
    Tong HC, Nelson VS (2000) Recurrent and migratory reflex sympathetic dystrophy in children. Pediatr Rehabil 4(2):87–89PubMedCrossRefGoogle Scholar
  10. 10.
    Rovetta G, Barotto L, Monteforte P (1999) Low dose gabapentin for shoulder–hand syndrome induced by phenobarbital: a three month study. Drugs Exp Clin Res 25:185–191PubMedGoogle Scholar
  11. 11.
    Bruehl S, Harden RN, Galer BS, Saltz S, Bertram M, Backonja M, Gayles R, Rudin N, Bhugra MK, Stanton-Hicks M (1999) External validation of IASP diagnostic criteria for Complex Regional Pain Syndrome and proposed research diagnostic criteria. International Association for the Study of Pain. Pain 81(1–2):147–154PubMedCrossRefGoogle Scholar
  12. 12.
    Taskaynatan MA, Ozgül A, Tan AK (2004) Bier block with methylprednisolone and lidocaine in CRPS type I: a randomized, double-blinded, placebo-controlled study. Reg Anesth Pain Med 29(5):408–412PubMedCrossRefGoogle Scholar
  13. 13.
    Taskaynatan MA, Balaban B, Karlýdere T, Ozgül A, Tan AK (2005) Factitious disorders encountered in patients with the diagnosis of reflex sympathetic dystrophy. Clin Rheumatol 24(5):521–526PubMedCrossRefGoogle Scholar
  14. 14.
    Rho RH, Brewer RP, Lamer TJ (2002) Complex regional pain syndrome. Mayo Clin Proc 77:174–180PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2006

Authors and Affiliations

  • Arif Kenan Tan
    • 1
  • Iltekin Duman
    • 1
    Email author
  • Mehmet Ali Taşkaynatan
    • 1
  • Bülent Hazneci
    • 1
  • Tunc Alp Kalyon
    • 1
  1. 1.Department of Physical Medicine and RehabilitationGulhane Military Medical AcademyEtlikTurkey

Personalised recommendations