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Gabapentinoids should not be used for chronic low back pain, meta-analysis concludes

BMJ 2017; 358 doi: (Published 16 August 2017) Cite this as: BMJ 2017;358:j3870
  1. Jacqui Wise
  1. London

Gabapentinoids, including pregabalin and gabapentin, are increasingly being used off label to treat chronic low back pain, but a systematic review and meta-analysis in PLoS Medicine has concluded that the existing evidence does not support such use.1

In the United States pregabalin is a controlled substance, and calls have been growing for it to be reclassified in the United Kingdom to help tackle widespread misuse and addiction.

Pregabalin and gabapentin are anticonvulsant drugs with a well defined role in managing long term conditions such as epilepsy, post-herpetic neuralgia, and neuropathic pain. Pregabalin is also licensed for treating generalised anxiety disorder. Both drugs, however, are also increasingly being used off label for almost any type of pain.

The Canadian researchers found that, despite widespread use of gabapentinoids, very …

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