Presentation (CTI)

OBJECTIVES: The treatment of chronic pain is complex, and clinical trials have suggested that gabapentin and amitriptyline are effective treatment options for chronic pain. We aimed to compare the efficacy of gabapentin and amitriptyline in the treatment of chronic pain.
METHODS: We conducted a comprehensive search of electronic databases, including PubMed, Cochrane Library, and Google Scholar, from inception to September 20, 2023. An advanced search strategy was employed to identify relevant studies on the use of gabapentin and amitriptyline for chronic pain management. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcomes were pain intensity and pain threshold, evaluated to compare the efficacy of gabapentin and amitriptyline in chronic pain management.
RESULTS: Eight randomized controlled trials (RCTs) involving 636 participants were analyzed. Four trials indicated that gabapentin demonstrated better efficacy than amitriptyline, whereas two trials found that amitriptyline was more effective than gabapentin. Four RCTs reported gabapentin had a higher pain threshold than amitriptyline, whereas the remaining studies showed amitriptyline had a lower pain threshold than gabapentin.
CONCLUSIONS: This systematic review demonstrated that gabapentin has comparable or superior efficacy to amitriptyline in chronic pain management. Future research should focus on specific subpopulations to determine whether certain groups respond better to one medication and assess the long-term effectiveness of the studied drugs and other first-line treatments for chronic pain to gain a more comprehensive understanding of optimal pain management strategies.