Gabapentin add-on for drug-resistant partial epilepsy

  • Review
  • Intervention




The majority of people with epilepsy have a good prognosis and their seizures are well controlled by a single antiepileptic drug, but up to 30% develop refractory epilepsy, especially those with partial seizures. In this review we summarize the current evidence regarding a new antiepileptic drug, gabapentin, when used as an add-on treatment for drug-resistant partial epilepsy


To evaluate the efficacy and tolerability of gabapentin when used as an add-on treatment for people with drug-resistant partial epilepsy.

Search methods

We searched the Cochrane Epilepsy Group's Specialized Register (July 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2007), and MEDLINE (1966 to July 2007). No language restrictions were imposed. We also contacted the manufacturers of gabapentin and researchers in the field to seek any ongoing or unpublished studies.

Selection criteria

Randomized placebo controlled double blind add-on trials of gabapentin in people with drug-resistant partial epilepsy.

Data collection and analysis

Two review authors independently selected trials for inclusion and extracted the relevant data. The following outcomes were assessed: (a) 50% or greater reduction in seizure frequency; (b) treatment withdrawal (any reason); (c) adverse effects. Primary analyses were intention-to-treat. Sensitivity best and worst case analyses were also undertaken. Summary odds ratios were estimated for each outcome. Dose response was evaluated in regression models, and Number Needed to Treat (NNT) was calculated for individual doses.

Main results

Five trials were included representing 997 randomized participants.
Overall odds ratio (OR) with 95% confidence intervals (CIs) for 50% or greater reduction in seizure frequency compared to placebo was 1.93 (95% CI 1.37 to 2.71). Dose regression analysis shows increasing efficacy with increasing dose, with 28.5% (21.5 to 36.7) of people responding to 1800 mg of gabapentin compared to placebo, NNT 6.7 (3.0 to 10.5).
Treatment withdrawal OR (95% CI) compared to placebo was 1.05 (95% CI 0.68 to 1.61).
Adverse effects with OR (99% CI) compared to placebo: dizziness 2.22 (99% CI 1.28 to 3.85); fatigue 2.28 (99% CI 1.15 to 4.52) and somnolence 2.01 (99% CI 1.24 to 3.28) were significanty associated with gabapentin.

Authors' conclusions

Gabapentin has efficacy as an add-on treatment in people with drug-resistant partial epilepsy. However, trials reviewed were of relatively short duration, and provide no evidence for the long-term efficacy of gabapentin. Results cannot be extrapolated to monotherapy or people with other epilepsy types.








我們搜尋了Cochrane Epilepsy Group's Specialized Register(2005年5月)以及Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library,2005年第2期) 和MEDLINE (1966年2005年3月)。沒有設定任何語言限制。我們同時聯繫Gabapentin的製造商和該領域的研究者,尋找進行中或未發表的研究。




兩位回顧作者各自選擇收納試驗和摘錄數據。評估了下列治療成果:(a) 癲癇發作頻率降低50% 或以上;(b) 停止試驗用藥(不論任何原因);(c) 藥物不良反應。初步分析採用intentiontotreat方法’.同時實施了Sensitivity best and worst case analyses。對每項治療成果評估了總體的odds ratios。使用回歸模型評估劑量與反應的相關性,計算Number Needed to Treat (NNT)。


總共收納了5個試驗,包括997位隨機挑選的受試者。相較於安慰劑,Gabapentin在達成癲癇發作頻率降低50% 或以上的odds ratio(OR)是1.93 (95% CI 1.37 −2.71)。劑量回歸分析指出,劑量越大療效越強;相較於安慰劑,28.5% (21.5 – 36.7) 的人對1800 mg Gabapentin的治療有反應,NNT為6.7 (3.0 10.5)。相較於安慰劑,停藥的OR為1.05 (95% CI 0.68 – 1.61)。相對於安慰劑,下列藥物不良反應的OR分別為:頭暈2.22 (99% CI 1.28 – 3.85);疲勞2.28 (99% CI 1.15 – 4.52),嗜睡2.01 (99% CI 1.24 – 3.28) 均顯著和Gabapentin相關。




此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。



Plain language summary

Gabapentin add-on for drug-resistant partial epilepsy

Gabapentin is effective as a short-term add-on treatment for partial epilepsy.

Epilepsy is a disorder where recurrent seizures are caused by abnormal electrical discharges from the brain. The review of trials found that a new antiepileptic drug, gabapentin is effective in the short-term when used with other drugs by people with drug-resistant partial epilepsy. The most common adverse effects caused by gabapentin are ataxia (poor coordination and unsteady gait), dizziness, fatigue, nausea, drowsiness and headaches. Research is needed into the effects of the long-term use of gabapentin.