Jeff Langmaid explains why gabapentin, an anticonvulsant approved for neuropathic pain in 1993, is prescribed off-label for spine pain despite 2018 and 2022 systematic reviews finding no clear evidence it works for radicular low back pain.
1993
2018 and 2022
If you've been in practice more than one day, you've probably seen patients come into your practice that have been prescribed gabapentin for pain. Well, what is gabapentin? Gabapentin is actually an anticonvulsant, antiepileptic medication. That's what it's designed for. If you believe gabapentin is prescribed on label for spine related conditions, you are sadly mistaken. Even though this is prescribed literally millions of times per year, that is a problem. Do you think that most people that are taking gabapentin know that that's the case? I can guarantee you basically none of them do. Now, gabapentin has been supported by the FDA for approval for neuropathic pain conditions since 1993. If you think that's a stamp of approval, maybe we should have a whole different podcast on that. But this is despite the fact that Systematic reviews in 2018 and 2022 demonstrated clear evidence for its lack of effectiveness treating radicular low back pain.
