Wel of geen gabapentinoïden bij volwassenen met chronische neuropathische pijn?

Translated title of the contribution: Whether or not to use gabapentinoids in adults with chronic neuropathic pain

Eveline P van Poelgeest, Lina El Houssein, JanWillem Kallewaard, Markus W Hollmann, Monique A H Steegers, Hans C H Wartenberg

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

CASE DESCRIPTION: A frail 85-year-old woman with chronic neuropathic pain after hip surgery, not responding to treatment with acetaminophen and morphine patches. Should she be prescribed a gabapentinoid?

DISCUSSION: Gabapentinoids and antidepressants are considered first-line therapies. They achieve clinically relevant (i.e. ≥ 50%) pain reduction in approximately one-third of patients with postherpetic neuralgia and peripheral diabetic neuropathy. Evidence for other types of neuropathic pain is limited. Adverse events occur frequently and are mostly mild in nature; serious adverse effects are rare. Prescription of gabapentinoids in specific patient groups (e.g. elderly patients and patients with a history of depression or substance abuse) deserves careful consideration, because the risk/benefit ratio in those groups may be altered. In order to reduce the risk of withdrawal symptoms, slow tapering is recommended.

CONCLUSION: Chronic neuropathic pain often has a negative impact on the quality of life and is difficult to treat. In general, treatment with a gabapentinoid is a possible first-line treatment option. However, they may be relatively contraindicated in vulnerable patients.

Translated title of the contributionWhether or not to use gabapentinoids in adults with chronic neuropathic pain
Original languageDutch
Article numberD4797
JournalNederlands Tijdschrift voor Geneeskunde
Volume164
Issue number36
Publication statusPublished - 27 Aug 2020

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