Abstract
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.
Similar content being viewed by others
References
van de Vusse Anton C et al (2004) Randomized controlled trial of gabapentin in complex regional pain syndrome type I. BMC Neurol 4:13
Mellick GA, Mellick LB (1997) Reflex sympathetic dystrophy treated with gabapentin. Arch Phys Med Rehabil 78:98–105
Navani A, Rusy LM, Jacobson RD, Weisman SJ (2003) Treatment of tremors in complex regional pain syndrome. J Pain Symptom Manage 25(4):386–390
Mellick GA, Mellick LB (1995) Successful treatment of reflex sympathetic dystrophy with gabapentin. Am J Emerg Med 13:96
Epstein B, Childers MK (1998) The use of gabapentin for neuropathic and musculoskeletal pain: a case series. J Neurol Rehabil 12(2):81–85
Wheeler DS, Vaux KK, Tam DA (2000) Use of gabapentin in the treatment of childhood reflex sympathetic dystrophy. Pediatr Neurol 22:220–221
Maneksha FR, Mirza H, Poppers PJ (2000) Complex regional pain syndrome with resistance to local anesthetic block: a case report. J Clin Anesth 12:67–71
Mellick GA, Mellick LB (1995) Gabapentin in the management of reflex sympathetic dystrophy. J Pain Symptom Manage 10(4):265–266
Tong HC, Nelson VS (2000) Recurrent and migratory reflex sympathetic dystrophy in children. Pediatr Rehabil 4(2):87–89
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 25:185–191
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):147–154
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):408–412
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):521–526
Rho RH, Brewer RP, Lamer TJ (2002) Complex regional pain syndrome. Mayo Clin Proc 77:174–180
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tan, A.K., Duman, I., Taşkaynatan, M.A. et al. The effect of gabapentin in earlier stage of reflex sympathetic dystrophy. Clin Rheumatol 26, 561–565 (2007). https://doi.org/10.1007/s10067-006-0350-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-006-0350-y