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Treatment Effects of Gabapentin for Primary Insomnia

Lo, Hsiao-Sui MD*; Yang, Chien-Ming PhD; Lo, Helen G. MD; Lee, Chien-Ying MS§∥; Ting, Hua MD; Tzang, Bor-Show PhD**

doi: 10.1097/WNF.0b013e3181cda242
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Objectives: The prevalence of insomnia is very high in our society. Although pharmacological treatment of insomnia is available, most hypnotics have been shown to alter sleep architecture and have many adverse effects. Gabapentin was originally designed for antiepileptic therapy; however, some studies reported that its use increases slow-wave sleep in healthy volunteers or patients. Our goal was to evaluate the benefits of gabapentin in the treatment of primary insomnia in patients.

Methods: Eighteen patients with primary insomnia participated in the study. They received gabapentin treatment for at least 4 weeks. All patients received polysomnography, a biochemical blood test, and neuropsychological tests before and after the treatment period. All measures were analyzed with Student t test to examine the treatment effects of gabapentin, except that the measures of heart rate variability were analyzed with analysis of variance.

Results: Polysomnographic study revealed increased sleep efficiency and slow-wave sleep, decreased wake after sleep onset, and spontaneous arousal index after gabapentin treatment. The biochemical blood test revealed decreased prolactin levels in the morning after treatment. Electroencephalographic power spectral analysis showed increased delta-2 and theta power in sleep stage 1 and decreased sigma activity power in sleep stages N2 and N3 after gabapentin treatment. Heart rate variability analyses also showed a significant increase in normalized high frequency percentage in sleep stages N2 and N3 and low frequency-high frequency ratio in sleep stage N2 after treatment. In addition, neuropsychological tests revealed the elevation of visual motor processing speed after gabapentin treatment.

Conclusions: Gabapentin enhances slow-wave sleep in patients with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal. The results suggest that gabapentin may be beneficial in the treatment of primary insomnia.

*Department of Neurology and Sleep Center, Chung Shan Medical University and University Hospital, Tai-Chung; †Department of Psychology/Research Center for Mind, Brain, and Learning, National Cheng Chi University, Taipei, Taiwan; ‡Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA; §Institute of Medicine, Chung Shan Medical University; ∥Department of Pharmacy, Chung Shan Medical University Hospital; ¶Department of Rehabilitation and Sleep Center, and **Institute of Biochemistry and Biotechnology, Chung Shan Medical University, Tai-Chung, Taiwan.

Address correspondence and reprint requests to Chien-Ming Yang, PhD, Department of Psychology, National ChengChi University, Taipei, Taiwan; E-mail: dryangcm@gmail.com

The authors disclose that this study is not sponsored by any pharmaceutical company or other organization but only partial financial support from Taiwan Pfizer, Inc. The authors have no conflict of interest directly relevant to the contents of this article.

© 2010 Lippincott Williams & Wilkins, Inc.