Gabapentin and weight loss
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Gabapentin and Weight Change: A Comprehensive Review
Gabapentin and Weight Gain
Systematic Review and Meta-Analysis Findings
Gabapentin, a commonly prescribed medication for conditions such as epilepsy and neuropathic pain, has been associated with weight gain. A systematic review and meta-analysis encompassing 257 randomized trials found that gabapentin users experienced an average weight gain of 2.2 kg . This weight gain is significant compared to other medications and highlights the need for careful consideration when prescribing gabapentin, especially for patients concerned about weight changes.
Long-Term Gabapentin Therapy
In a study examining the long-term effects of high-dose gabapentin therapy in patients with seizure disorders, it was observed that a substantial number of patients experienced weight gain. Specifically, 10 out of 44 patients gained more than 10% of their baseline weight, and 15 patients gained between 5% to 10% of their baseline weight. The weight gain typically began between the second and third months of treatment and stabilized after 6 to 9 months, even though the dosage remained unchanged .
Gabapentin in Postherpetic Neuralgia
A study on the long-term safety of a gastroretentive formulation of gabapentin (G-GR) in patients with postherpetic neuralgia reported a mean weight gain of 0.76 kg over a 24-week period. Although the weight gain was relatively modest, it was still notable, with 2.5% of patients reporting weight increase as an adverse event .
Gabapentin Enacarbil and Weight Gain
Gabapentin enacarbil (GEn), a prodrug of gabapentin, was evaluated in a phase 2 trial for patients with painful diabetic peripheral neuropathy. The study found that weight gain was dose-dependent, with higher doses resulting in greater weight increases. The mean weight gain at the end of the 12-week maintenance phase was 1.22 kg for the 1200 mg dose, 1.71 kg for the 2400 mg dose, and 1.85 kg for the 3600 mg dose 45.
Comparison with Other Antiepileptic Drugs
Weight Gain with Other AEDs
Gabapentin is not the only antiepileptic drug (AED) associated with weight gain. Other AEDs such as pregabalin, valproic acid, and vigabatrin also contribute to weight increases. In contrast, some AEDs like lamotrigine, levetiracetam, and phenytoin are weight neutral, while topiramate and zonisamide are associated with weight loss 67.
Clinical Implications
The weight gain associated with gabapentin and other AEDs can have significant clinical implications. It is crucial for healthcare providers to monitor patients' weight regularly and consider the potential for weight gain when selecting an AED. This is particularly important for patients who are already overweight or have other risk factors for obesity-related conditions.
Conclusion
Gabapentin is associated with a notable risk of weight gain, which can vary depending on the dosage and duration of treatment. This side effect is shared with several other antiepileptic drugs, although some AEDs are weight neutral or even promote weight loss. Clinicians should weigh the benefits of gabapentin against the potential for weight gain and consider alternative treatments or strategies to mitigate this side effect. Regular monitoring and individualized treatment plans are essential to manage the overall health and well-being of patients on gabapentin therapy.
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