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  4. Adverse cognitive effect of gabapentin in individuals with spinal cord injury: preliminary findings

Adverse cognitive effect of gabapentin in individuals with spinal cord injury: preliminary findings

Spinal Cord Series and Cases, 2018 · DOI: https://doi.org/10.1038/s41394-018-0038-y · Published: January 1, 2018

Spinal Cord InjuryNeurologyPain Management

Simple Explanation

This study investigates the impact of gabapentin, a common medication for neuropathic pain, on cognitive functions like memory, attention, and executive function in individuals with spinal cord injury (SCI). The research involved administering neuropsychological tests to SCI patients before, one week after, and four weeks after starting gabapentin therapy to observe any changes in their cognitive performance. The preliminary findings suggest that gabapentin may be associated with a decline in cognitive function shortly after starting the medication, although further research is needed due to limitations such as small sample size and lack of a control group.

Study Duration
4 weeks
Participants
10 patients with traumatic spinal cord injury
Evidence Level
Prospective observational cohort study

Key Findings

  • 1
    The average score for six out of the nine neuropsychological items administered at 1 week post initiation of gabapentin displayed a decrease in cognitive function when compared to baseline.
  • 2
    The average score for five out of nine neuropsychological items improved from 1 week post initiation of treatment to 4 weeks post initiation of treatment.
  • 3
    Three out of the five test results displayed a decrease in cognitive function when assessed 1 week post treatment with gabapentin relating to attention.

Research Summary

This study assessed the cognitive effects of gabapentin in individuals with SCI, revealing a potential decline in cognitive function (memory, attention, and executive function) shortly after starting the medication. While some cognitive functions showed improvement after four weeks, the study's limitations (small sample size, lack of control group) prevent definitive conclusions regarding gabapentin's sole impact. The findings highlight the importance of considering potential cognitive side effects when prescribing gabapentin for neuropathic pain in SCI patients, advocating for shared decision-making between clinicians and patients.

Practical Implications

Informed Prescribing

Healthcare providers should be aware of the potential negative effects of gabapentin on cognitive function in SCI patients.

Shared Decision-Making

Clinicians should engage in shared decision-making with patients, discussing the benefits and risks of gabapentin, including potential cognitive decline.

Rehabilitation Impact

Diminished cognition could impact a patient’s ability to participate and learn during rehabilitation, potentially affecting long-term functional outcomes and independence.

Study Limitations

  • 1
    Small sample size
  • 2
    Loss of patient follow-up at the 4 week post-treatment assessment
  • 3
    Lack of a control group

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