Aim:  Neuropathic pain is a frequent complication of spinal cord injury. Almost 70% of persons with SCI experience pain and nearly one third of those patients describe their pain as severe. Gabapentin and pregabalin are considered to be the first-line treatment for post-SCI neuropathic pain. However; there is no study comparing the effects of gabapentin and pregabalin in the management of neuropathic pain in persons with SCI. In this prospective, randomized, crossover clinical trial; we aimed to compare the efficacy of gabapentin and pregabalin in the treatment of neuropathic pain related to spinal cord injury (SCI).

Methods:  Thirty spinal cord injured patients with neuropathic pain were recruited for the study. Patients took the medications for 8 weeks. After 2-week washout period, the medications were switched in a cross- over design. The outcome measures for this study were visual analogue scale (VAS) for pain, VAS for sleep, Short Form Beck Depression Inventory and pain disability index.

Results:  Twenty one patients completed the study. Seven patients who did not want to change their medication while they were using the first drug (4 patients were using gabapentin and 3 patients were using pregabalin) and 2 patients who experienced dizziness and nausea (both were in pregabalin group) were dropped off. There was no difference between both drugs in terms of the efficacy on pain, anxiety and sleep (p < 0.05).

Conclusions:  There is no statistically significant difference between gabapentin and pregabalin in terms of study parameters for the treatment of neuropathic pain in patients with SCI.