Comparison of the effect of topiramate versus gabapentin on neuropathic pain in patients with polyneuropathy: A randomized clinical trial

Neuropathic pain is one of the most common complaints of neurologic clinics. Neuropathic pain is
common and important and has inappropriate complications, and despite their importance, there is no effective
treatment for them.
Objective: Because of the importance of neuropathic pain and safe and effective treatment, in this study, we
determined the effect of topiramate versus gabapentin in patients with neuropathic pain.
Methods: In this randomized clinical trial, 30 patients with pain attributed to neuropathy who had at least one
month of neuropathic pain in one area, were randomized to receive either gabapentin, titrated from 300 mg/day to
a maximum of 900 mg/day or topiramate, titrated from 50 mg/day to a maximum of 100 mg/day after a 4-week
period in the neurology clinic of Imam Khomeini Hospital of Urmia city, Iran in 2015. Complication, drug
tolerance rate and pain were investigated. The pain was measured on visual analog scale (VAS). The data were
analyzed by SPSS version 18, and using descriptive statistics, t-test, and ANOVA.
Results: In patients treated by gabapentin, the primary pain score was 74.33±10.29, this score decreased to
49.46±11.41 and 29.93±11.92 in the second and fourth week after intervention with gabapentin. In topiramate
treated patients, the primary score was 76.00±9.69. It decreased to 54.33±10.31 and 34.20±6.09 at the same time.
There were no significant differences between both groups in terms of average reduction of pain intensity
[gabapentin group (59.73%) compared with topiramate (55%) (p=0.48)]. In the present study, the only
complication reported in patients treated by gabapentin was drowsiness, but other uncommon side effects were
nausea and dizziness.
Conclusion: This study showed that both gabapentin and topiramate reduce pain. Topiramate can also be a good
alternative choice, if gabapentin has side effects for patients and it cannot be tolerated, topiramate can be a good
replacement.
Trial registration: The trial was registered at the Thai Registry of Clinical Trials (http://www.clinicaltrials.in.th)
with the TCTR ID: TCTR20170615001.
Funding: This research has been financially supported by Research Council of Urmia University of Medical
Sciences