Comparative study of efficacy and safety of pregabalin and gabapentin in neuropathic pain

Neuropathic pain differs from nociceptive pain by their causation, character and also mode of treatment. Most neuropathic pain responds poorly to non steroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics. Pregabalin and gabapentin have been extensively studied in the treatment of neuropathic pain but there is no evidence to indicate superiority of one of these drugs above the other. So, in this study our aim was to compare their efficacy and safety in neuropathic pain. A randomized assessor blind unicentric fixed dose study of pregabalin and gabapentin in treatment of neuropathic pain was conducted in 100 patients attending Neurology OPD of R.G.Kar Medical College, Kolkata. These 100 patients were divided in 2 groups, 50 patients were received pregabalin 75 mg twice daily and other group of 50 patients were received gabapentin 300 mg twice daily for consecutive 8 weeks. Both the groups of patients were followed up at 2, 4 and 8 weeks after starting study drugs and reduction in quantity and quality of pain were assessed by Visual analogue scale (VAS) and pain quality assessment scale (PQAS). Friedman’s test was applied followed by Dunn’s multiple comparison test and it showed that both the drugs reduce VAS score similarly but for PQAS score, Pregabalin has resulted superiority earlier than gabapentin. Also, total reduction of PQAS score from 0 to 8 weeks in pregabalin group is highly significant (p= .0146) in comparison to reduction in gabapentin group, measured by unpaired t test. So, pregabalin has significant better result in reduction of pain quality than gabapentin after 8 weeks of treatment. No similar result was obtained while comparing their reduction in pain intensity.