Fragoso Y D, Carrazana E J
Universidade Federal de Sao Paulo, SP, Brazil.
MedGenMed. 2000 Aug 21;2(3):E52.
The difficult management of chronic daily headache and the lack of clinical trials for this medical condition led the authors to perform this study. Gabapentin has been successfully used for a variety of chronic pain conditions and therefore may be of use in the treatment of chronic headache.
To assess the efficacy and safety of low doses of gabapentin in cases of chronic daily headache.
Open-label study on a series of cases of chronic daily headache.
Twenty-one consecutive patients with primary headache lasting 4 or more hours a day, at least 15 days per month, were invited to participate in this open trial. They were treated with low doses of gabapentin for sufficient time to lead to a headache-free period of at least 7 consecutive days. A minimum of 1 follow-up visit and 1 phone call were made in the subsequent 6-9 months.
A simple "Patient Impression of Change" was used to evaluate the results. Patients were also invited to compare this treatment to previous ones, whenever possible.
The efficacy of the treatment with gabapentin was rated as "excellent" by 19% of the patients, "good" by 47.6%, "fair" by 19%, and "poor" by 14.4%.
Despite the inherent limitations of such a small open trial, the authors concluded that ratings of excellent and good by two thirds of this population of patients with chronic daily headache should encourage the setup of a large double-blind, multicentric, placebo-controlled trial of low doses of gabapentin for chronic daily headache.
慢性每日头痛的治疗困难，且针对这种病症缺乏临床试验，这促使作者开展此项研究。加巴喷丁已成功用于多种慢性疼痛病症，因此可能对慢性头痛的治疗有用。
评估低剂量加巴喷丁治疗慢性每日头痛的疗效和安全性。
对一系列慢性每日头痛病例进行的开放标签研究。
连续邀请21例原发性头痛患者参与这项开放试验，这些患者每天头痛持续4小时或更长时间，每月至少15天。他们接受低剂量加巴喷丁治疗足够长的时间，以实现至少连续7天无头痛期。在随后的6至9个月内至少进行1次随访就诊和1次电话随访。
使用简单的“患者对变化的印象”来评估结果。尽可能邀请患者将这种治疗与之前的治疗进行比较。
19%的患者将加巴喷丁治疗的疗效评为“优秀”，47.6%评为“良好”，19%评为“中等”，14.4%评为“差”。
尽管如此小的开放试验存在固有局限性，但作者得出结论，三分之二的慢性每日头痛患者将疗效评为优秀和良好，这应促使开展一项针对低剂量加巴喷丁治疗慢性每日头痛的大型双盲、多中心、安慰剂对照试验。
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