Tiagabine and gabapentin for the management of chronic pain

Objective: Agents that modulate gamma-aminobutyric acid transmission, such as gabapentin, are widely used for the management of chronic pain disorders/syndromes, however, the usefulness of the selective gamma-aminobutyric acid reuptake inhibitor tiagabine in this therapeutic area has yet to be investigated. This study evaluated the effectiveness and safety of tiagabine and gabapentin for the treatment of chronic pain. Methods: This 3-month, open-label, comparative study randomized 91 patients with chronic pain to receive either tiagabine (maximum dose 24 mg/day) or gabapentin (2400 mg/day). Patients rated their pain intensity and sleep quality using 11-point (0-10) scales prior to treatment and after 3 months of continuous treatment. Results: Of the 46 patients receiving tiagabine, 36 (78%) completed the study; 38 of 45 patients (84%) receiving gabapentin completed the study. Tiagabine and gabapentin significantly reduced pain intensity and improved sleep quality at 3 months, compared with baseline (P < 0.01). Improvements in sleep quality were significantly greater in tiagabine versus gabapentin-treated patients (P = 0.04). Conclusions: These results suggest that tiagabine and gabapentin are effective in the management of chronic pain, with tiagabine having a greater beneficial effect on sleep quality.