Gabapentin weight gain
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Gabapentin and Weight Gain: A Comprehensive Review
Introduction to Gabapentin and Weight Gain
Gabapentin, a medication commonly used to treat neuropathic pain and seizure disorders, has been associated with weight gain in some patients. This article synthesizes findings from multiple studies to provide a clear understanding of the relationship between gabapentin and weight gain.
Incidence of Weight Gain with Gabapentin
Clinical Trials and Observations
Several studies have documented weight gain as a side effect of gabapentin. In a review of 44 patients treated with gabapentin for seizure disorders over 12 months, weight gain was observed in a significant number of patients. Specifically, 10 patients gained more than 10% of their baseline weight, and 15 patients gained between 5% to 10% of their baseline weight. Weight gain typically began between the second and third months of treatment and stabilized after 6 to 9 months, even when the dosage remained unchanged3.
Comparative Studies with Other Medications
In a phase 2 trial comparing gabapentin enacarbil (GEn), a prodrug of gabapentin, with pregabalin and placebo in patients with painful diabetic peripheral neuropathy (DPN), GEn was associated with lower incidences of weight gain compared to pregabalin. The incidences of weight gain for GEn were 0% (1200 mg), 4% (2400 mg), and 4% (3600 mg), while pregabalin had an 8% incidence and placebo had a 1% incidence. The mean weight gain at the end of the 12-week maintenance phase was 1.22 kg, 1.71 kg, and 1.85 kg for GEn 1200, 2400, and 3600 mg, respectively, compared to 2.65 kg for pregabalin and a weight loss of 0.55 kg for placebo1 2.
Long-term Safety and Weight Gain
A study on the long-term safety of a gastroretentive formulation of gabapentin (G-GR) in patients with postherpetic neuralgia (PHN) found that the mean weight change over a 24-week period was +0.76 kg. Only 2.5% of patients reported weight gain as an adverse event, indicating that long-term treatment with G-GR was associated with minimal weight gain4.
Meta-Analysis and Systematic Reviews
A systematic review and meta-analysis of various drugs associated with weight change found that gabapentin was linked to an average weight gain of 2.2 kg. This analysis included data from multiple randomized trials, providing robust evidence of gabapentin's potential to cause weight gain5.
Conclusion
Gabapentin is associated with weight gain in a subset of patients, with the extent of weight gain varying based on dosage and duration of treatment. Comparative studies indicate that gabapentin enacarbil may result in less weight gain compared to pregabalin. Long-term studies suggest that weight gain with gabapentin is generally modest. These findings highlight the importance of monitoring weight in patients undergoing gabapentin therapy and considering alternative treatments if significant weight gain occurs.
Sources and full results
Most relevant research papers on this topic
Peripheral Edema and Weight Gain in Adult Patients with Painful Diabetic Peripheral Neuropathy (DPN) Receiving Gabapentin Enacarbil (GEn) or Pregabalin Enrolled in a Randomized Phase 2 Trial (I6-1.004)
In a phase 2 study, GEn was associated with lower incidences of peripheral edema and weight gain than pregabalin, with weight gain in GEn-treated patients appearing to be dose-dependent.
RCT
Large Human Trial
Rigorous JournalPeripheral Edema and Weight Gain in Adult Patients with Painful Diabetic Peripheral Neuropathy (DPN) Receiving Gabapentin Enacarbil (GEn) or Pregabalin Enrolled in a Randomized Phase 2 Trial (I6-1.004)
In a phase 2 study, GEn was associated with lower incidences of peripheral edema and weight gain than pregabalin, with weight gain appearing dose-dependent.
RCTLarge Human TrialRigorous JournalChanges in body weight with chronic, high-dose gabapentin therapy.
Chronic, high-dose gabapentin therapy may cause weight gain in some patients, with weight stabilization after 6 to 9 months.
Observational Study
Highly CitedLong-term Safety of Gastroretentive Gabapentin in Postherpetic Neuralgia Patients
Long-term treatment with a gastroretentive formulation of gabapentin (G-GR) of 1800 mg is well tolerated and associated with little weight gain (1 kg) in postherpetic neuralgia patients.
RCTClinical review: Drugs commonly associated with weight change: a systematic review and meta-analysis.
Several drugs are associated with weight change, guiding drug choice and preemptive weight loss strategies when obesogenic drugs are prescribed.
Meta-AnalysisRigorous JournalHighly CitedEffect of gabapentin on hyperemesis gravidarum: a double-blind, randomized controlled trial.
Gabapentin treatment significantly reduces nausea and vomiting in hyperemesis gravidarum patients compared to standard-of-care therapies, improving oral nutrition and overall quality of life.
RCTAn acute gabapentin fatality: a case report with postmortem concentrations
Acute gabapentin ingestion can cause fatalities, with postmortem concentrations showing elevated levels in the body.
Case ReportGabapentin concentrations and postmortem distribution.
Gabapentin is unlikely to show postmortem redistribution, as its concentrations remain consistent in both antemortem and postmortem specimens.
Case ReportWeight issues for people with epilepsy—A review
Epilepsy drugs may cause weight changes, and regular weighing and individualized drug selection is crucial for maintaining optimal health.
Literature ReviewHighly CitedAlpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use
Alpha2delta ligands, such as gabapentin and pregabalin, effectively treat neuropathic pain, fibromyalgia, and epilepsy, with potential for use in treating generalized anxiety disorder and restless legs syndrome.
Systematic ReviewHighly Cited