Does gabapentin lower heart rate
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Gabapentin and Its Effects on Heart Rate
Introduction to Gabapentin and Cardiovascular Responses
Gabapentin, a GABA analogue, is widely used for treating neuropathic pain and seizures. Recent studies have explored its impact on cardiovascular functions, particularly its ability to modulate heart rate (HR) and blood pressure (BP). This article synthesizes findings from multiple research studies to determine whether gabapentin lowers heart rate.
Gabapentin's Impact on Heart Rate During Anesthesia
Several studies have investigated gabapentin's effects on heart rate during anesthesia, particularly in response to laryngoscopy and tracheal intubation. A study involving 90 normotensive patients found that a dose of 800 mg gabapentin significantly decreased heart rate and arterial pressure after intubation compared to placebo and lower doses of gabapentin1. Another study with 46 patients undergoing abdominal hysterectomy reported that gabapentin attenuated the pressor response but did not significantly affect heart rate during the first 10 minutes post-intubation5. Similarly, a study comparing different doses of gabapentin (600 mg and 1000 mg) found that the higher dose significantly reduced heart rate within 10 minutes of intubation10.
Hemodynamic Responses in Hypertensive Models
Research on spontaneously hypertensive rats (SHR) has shown that gabapentin can lower heart rate and blood pressure. Acute administration of gabapentin in SHR resulted in a significant reduction in heart rate, attributed to decreased peripheral sympathetic nerve transmission2. Another study demonstrated that gabapentin's cardiovascular effects in the nucleus tractus solitarii (NTS) of SHR were mediated through nitric oxide synthase (NOS) signaling, leading to dose-related depressor and bradycardic effects4.
Chronic Gabapentin Treatment and Cardiovascular Function
Chronic administration of gabapentin has also been studied for its cardiovascular effects. In a preclinical model using rats, chronic gabapentin treatment resulted in hypotension and bradycardia, indicating suppressed cardiovascular function3. This suppression was linked to abnormal calcium signaling in cardiomyocytes, suggesting a novel side effect of gabapentin independent of the nervous system.
Gabapentin and Heart Rate Variability in Diabetic Patients
In diabetic patients with peripheral neuropathy, gabapentin therapy has been shown to improve heart rate variability (HRV), a measure of autonomic function. After three months of gabapentin treatment, significant improvements in HRV parameters were observed, indicating enhanced cardiac autonomic function8.
Conclusion
The evidence suggests that gabapentin can lower heart rate, particularly in acute settings such as anesthesia induction and in hypertensive models. Chronic administration also appears to suppress cardiovascular function, leading to bradycardia. Additionally, gabapentin improves heart rate variability in diabetic patients, further supporting its role in modulating heart rate. These findings highlight gabapentin's potential benefits and risks in cardiovascular health, warranting careful consideration in clinical use.
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Most relevant research papers on this topic
Gabapentin reduces cardiovascular responses to laryngoscopy and tracheal intubation
Oral gabapentin 800 mg given 1 hour before surgery effectively reduces arterial pressure and heart rate increase during tracheal intubation.
RCT
Highly CitedHemodynamic Response to Gabapentin in Conscious Spontaneously Hypertensive Rats: The Role of Sympathetic Nervous System
Acute gabapentin administration lowers blood pressure more effectively in spontaneously hypertensive rats than in Wistar-Kyoto rats, with N-type voltage-dependent calcium channels playing a key role in this response.
Non-RCT
Animal Study
Very Rigorous JournalEffects of Acute and Chronic Gabapentin Treatment on Cardiovascular Function of Rats
Acute and chronic gabapentin treatments suppress cardiovascular function in rats, mainly due to abnormal calcium signaling in cardiomyocytes.
Non-RCTAnimal StudyGabapentin Reduces Blood Pressure and Heart Rate through the Nucleus Tractus Solitarii.
Gabapentin reduces blood pressure and heart rate in hypertensive rats through the nucleus tractus solitarii, with its cardiovascular effects attenuated by the NOS inhibitor L-NAME.
Non-RCTAnimal StudyGabapentin attenuates the pressor response to direct laryngoscopy and tracheal intubation.
Gabapentin before surgery reduces the pressor response to laryngoscopy and tracheal intubation, but not tachycardia, without affecting heart rate.
RCTHighly CitedOral Gabapentin Pretreatment to Attenuate the Haemodynamic Response to Laryngoscopy and Tracheal Intubation
Oral gabapentin 900 mg two hours before induction effectively reduces blood pressure and heart rate after laryngoscopy and tracheal intubation, with a significant difference observed 10 minutes after intubation.
RCTBehavioral and cardiovascular effects of a single dose of gabapentin or melatonin in cats: a randomized, double-blind, placebo-controlled trial
A single dose of gabapentin or melatonin can reduce anxiety in cats before cardiac evaluations without interfering with heart rate, systemic blood pressure, electrocardiogram, and echocardiographic indexes.
RCTAnimal StudyGabapentin therapy improves heart rate variability in diabetic patients with peripheral neuropathy.
Gabapentin therapy improves heart rate variability and reduces neuropathic symptoms in diabetic patients with peripheral neuropathy.
Non-RCTUse of gabapentin, esmolol or their combination to attenuate haemodynamic response to laryngoscopy and intubation.
Gabapentin and esmolol can safely reduce the haemodynamic response to laryngoscopy and intubation without significant side effects.
RCTA Comparison of Different Doses of Gabapentin to Attenuate the Haemodynamic Response to Laryngoscopy and Tracheal Intubation in Normotensive Patients
Gabapentin1000 mg given 1 hour before surgery significantly attenuated the hemodynamic response to laryngoscopy and intubation in normotensive patients.
RCT
Rigorous Journal