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Gabapentin effect on spasticity in multiple sclerosis: a placebo-controlled, randomized trial.

Abstract

OBJECTIVE

To investigate the effect of gabapentin on subject self-report and physician-administered spasticity scales in individuals with multiple sclerosis.

DESIGN

Prospective, double-masked, placebo-controlled, crossover design.

SETTING

The Multiple Sclerosis Center at the Denver Veterans Affairs Medical Center.

INTERVENTION

Subjects were titrated to either 900 mg gabapentin orally three times a day or placebo over a 6-day period. Subjects underwent a 14-day washout and then were crossed over. No other changes were made to their medication regimen.

MAIN OUTCOME MEASURES

The outcome measures were divided into two categories: subject self-report scales physician-administered scales. Subject self-report scales included the spasm frequency scale, spasm severity scale, interference with function scale, painful spasm scale, and global assessment scale. Physician-administered scales included the Modified Ashworth Scale, clonus scale, deep tendon reflexes, plantar stimulation response, and the Kurtzke Expanded Disability Status (EDSS) Scale. Digit Span and Digit Symbol subtests of the WAIS-R Intelligence Scale were administered to assess for possible impaired concentration. The Fatigue Impact Scale was administered to assess for changes in fatigue. The adjective generation technique was administered to assess for alterations in mood.

RESULTS

A statistically significant reduction in the impairment of spasticity was found in the gabapentin-treated subjects compared with placebo as measured by the self-report scales of the spasm severity scale, interference with function scale, painful spasm scale, and global assessment scale and by the physician-administered scales of the Modified Ashworth and plantar stimulation response. No significant difference was noted in the Digit Span, Digit Symbol, adjective generation technique, and EDSS.

CONCLUSION

Gabapentin reduces the impairment of spasticity, compared with placebo, without the side effects of worsening concentration and fatigue.

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  • Authors+Show Affiliations

    ,

    University of Colorado Health Sciences Center, Denver, USA.

    , ,

    Source

    MeSH

    Acetates
    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Amines
    Anticonvulsants
    Cross-Over Studies
    Cyclohexanecarboxylic Acids
    Disability Evaluation
    Double-Blind Method
    Female
    Gabapentin
    Humans
    Male
    Middle Aged
    Multiple Sclerosis
    Muscle Fatigue
    Muscle Spasticity
    Prospective Studies
    Treatment Outcome
    gamma-Aminobutyric Acid

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, U.S. Gov't, Non-P.H.S.

    Language

    eng

    PubMed ID

    10668769

    Citation

    Cutter, N C., et al. "Gabapentin Effect On Spasticity in Multiple Sclerosis: a Placebo-controlled, Randomized Trial." Archives of Physical Medicine and Rehabilitation, vol. 81, no. 2, 2000, pp. 164-9.
    Cutter NC, Scott DD, Johnson JC, et al. Gabapentin effect on spasticity in multiple sclerosis: a placebo-controlled, randomized trial. Arch Phys Med Rehabil. 2000;81(2):164-9.
    Cutter, N. C., Scott, D. D., Johnson, J. C., & Whiteneck, G. (2000). Gabapentin effect on spasticity in multiple sclerosis: a placebo-controlled, randomized trial. Archives of Physical Medicine and Rehabilitation, 81(2), pp. 164-9.
    Cutter NC, et al. Gabapentin Effect On Spasticity in Multiple Sclerosis: a Placebo-controlled, Randomized Trial. Arch Phys Med Rehabil. 2000;81(2):164-9. PubMed PMID: 10668769.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gabapentin effect on spasticity in multiple sclerosis: a placebo-controlled, randomized trial. AU - Cutter,N C, AU - Scott,D D, AU - Johnson,J C, AU - Whiteneck,G, PY - 2000/2/11/pubmed PY - 2000/2/26/medline PY - 2000/2/11/entrez SP - 164 EP - 9 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 81 IS - 2 N2 - OBJECTIVE: To investigate the effect of gabapentin on subject self-report and physician-administered spasticity scales in individuals with multiple sclerosis. DESIGN: Prospective, double-masked, placebo-controlled, crossover design. SETTING: The Multiple Sclerosis Center at the Denver Veterans Affairs Medical Center. INTERVENTION: Subjects were titrated to either 900 mg gabapentin orally three times a day or placebo over a 6-day period. Subjects underwent a 14-day washout and then were crossed over. No other changes were made to their medication regimen. MAIN OUTCOME MEASURES: The outcome measures were divided into two categories: subject self-report scales physician-administered scales. Subject self-report scales included the spasm frequency scale, spasm severity scale, interference with function scale, painful spasm scale, and global assessment scale. Physician-administered scales included the Modified Ashworth Scale, clonus scale, deep tendon reflexes, plantar stimulation response, and the Kurtzke Expanded Disability Status (EDSS) Scale. Digit Span and Digit Symbol subtests of the WAIS-R Intelligence Scale were administered to assess for possible impaired concentration. The Fatigue Impact Scale was administered to assess for changes in fatigue. The adjective generation technique was administered to assess for alterations in mood. RESULTS: A statistically significant reduction in the impairment of spasticity was found in the gabapentin-treated subjects compared with placebo as measured by the self-report scales of the spasm severity scale, interference with function scale, painful spasm scale, and global assessment scale and by the physician-administered scales of the Modified Ashworth and plantar stimulation response. No significant difference was noted in the Digit Span, Digit Symbol, adjective generation technique, and EDSS. CONCLUSION: Gabapentin reduces the impairment of spasticity, compared with placebo, without the side effects of worsening concentration and fatigue. SN - 0003-9993 UR - https://www.unboundmedicine.com/medline/citation/10668769/Gabapentin_effect_on_spasticity_in_multiple_sclerosis:_a_placebo_controlled_randomized_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(00)90135-7 DB - PRIME DP - Unbound Medicine ER -