use of gabapentin in the control of endometriotic pain

Endometriotic pain is a combined nociceptive and neuropathic pain. Nociceptive endometriotic pain is caused by infiltrating endometrtotic lesions as well as fibrotic traction on different pelvic contents. Neuropathic endomnetriotic pain is due to nerve infiltration by endometriotic lesions, fibrotic traction on the nerve, and nerve irritation by inflammator mediators and cytokines in peritoneal fluids. The study was conducted on 33 patients with pain as the only or main symptom. All patients received hormonal and NSAIDs [ +/- Tramadol] treatment for at least 6 months and pain failed to be controlled. All patients received gabapentin for 3 months. Pain was evaluated using SF McGill mean overall pain score and NRS to evaluate the intensity of deep dyspareunia and dysmenorrhea. Serum IL-6 and CA-125 were evaluated. There is a significant improvement of SF McGill mean overall pain score. deep dyspareunia and dysmenorrhea 2 weeks, 4 weeks and 3 months after treatment. SF McGill mean overall pain score showed significant improvement with the rates of 46.54%, 56.18% and 59.31% at 2 weeks. 4 weeks and 3 months respectively. Also, deep dyspareunia showed significant improvement in the rates of 30. 76%, 52.14% and 58.12% at 2 weeks, 4 weeks and 3 months respectively. Dysmenorrhea showed improvement with the rates of 18.87%. 2 7.52% and 35.85% at 2 weeks. 4 weeks and 3 months respectively [All shows P value < 0.01]. This was associated with different degrees of clinical improvement in 72.73% of patients. Serum levels of IL6 showed significant decrease after 3 months with the treatment [P-value < 0.05] while CA-125 showed insignificant decrease of serum levels with treatment [P-value> 0.05]. This study proved an effective role of GABAPENTIN, not only in controlling the mean overall endometriotic pain, but also in deep dyspareunia and dysmenorrhea. This pain control is associated with significant decrease in the level of IL-6, but not CA-125

Gabapentin and sodium valproate: a comparative study

Gabapentin [GBP], a new antiepileptic drug with proven efficacy in the control of partial epilepsy, and is suggested to be a more favorable alternate to sodium valproate [SVP] in the control of generalized epileptic seizures as it has less side effects and a more favorable pharmacokinetic properties. In view of the gama aminobutyric acid [GABA] enhancing properties of GBP and SVP and the documented involvement of GABA in the control of cognitive functions, it is theoretically suggested that both drugs may affect the cognitive functions. To compare the anticonvulsant activity of SVP and GBP and compare the effects of both drugs on motor coordination and cognitive functions. The anticonvulsant effects of serial intraperitoneal [IP] doses of SVP and GBP were compared in mice using the maximal electroshock stimulation [MES] and subcutaneous pentylenetetrazole [scPTZ] stimulation tests. The effects of serial IP doses of SVP and GBP on motor coordination were compared in mice using the righting reflex and the rotarod tests. The effects of single IP injection and of chronic oral administration of SVP, GBP or both were compared in rats using the passive avoidance test. Both SVP and GBP produced significant anticonvulsant activity in the MES test but the median effective dose [ED50], as calculated by Litchefield and Wilcoxon, of SVP [115 mg/kg] was significantly lower than ED50 of GBP [140 mg/kg]. SVP produced significant anticonvulsant activity in the scPTZ test [ED50: 110 mg/kg] while GBP didn't produce a significant effect. SVP produced significantly more impairment of motor performance in the righting and rotarod tests. The median toxic dose was [TD50] of SVP was 350 mg/kg, and for GBP was 750 mg/kg. SVP produced significant inhibition of learning and memory retention after acute and chronic administration. On the other hand, GBP didn't produce any observable effect on learning or memory. GBP is likely to be clinical effective as a single agent therapy in generalized tonic clonic convulsions but not in generalized absence seizures. GBP is less likely than SVP to cause impairment of motor coordination and cognitive functions