Gabapentin treatment for muscle cramps: An open-label trial

To evaluate the efficacy and safety of gabapentin in the treatment of muscl e cramps, we engaged an open-label trial with a group of 30 patients with f requent (>5 cramps/week), stable, long-lasting cramps, associated with diff erent diseases. Gabapentin was effective in reducing the frequency and seve rity of muscle cramps and associated sleep disturbances (clinical outcome m easures) within the first 2 weeks of medication at 600 mg/d. At the 1 month control (mean dosage, 825 +/- 35 mg), almost every patient had responded t o treatment and two thirds experienced a total remission of symptoms. After 3 months of therapy (mean dosage, 892 +/- 180 mg), cramps disappeared in 1 00% of patients and this benefit persisted as long as 6 months. Additionall y, we evaluated in 10 patients the Cramps Threshold Frequency (CTF) (neurop hysiological outcome measure) before and during gabapentin treatment. Gabap entin significantly increased the CTF, returning it to normal values. With the limitation of an open-label methodology, our clinical and neurophysiolo gic experience suggests that a gabapentin dose of 600-1200 mg/d would be he lpful in the treatment of muscular cramps.