Gabapentin for Spasticity in Multiple Sclerosis – Absence of Efficacy in a Placebo Controlled Study

The use of Gabapentin for management of spasticity has become part of clinical guidelines despite a lack of objective scientific data. This is due to the problems associated with user dependent and insensitive to change clinical assessment tools. We sought to redress this using the Wartenberg's pendulum test. This is objective and sensitive to detect changes in spasticity. All patients had stable disease and did not have any changes to their medications within 30 days of the trial. If the patients were on muscle relaxants (namely Baclofen and tizanidine), these were stopped 10 days prior to the study. Patients were randomized to receive a single dose of either placebo (Ascorbic Acid), Gabapentin 300mg or Gabapentin 900mg, each at weekly intervals in a crossover manner. We found no evidence of any effect on spasticity at either dosage when compared with placebo. Our data does not support the use of Gabapentin for management of spasticity in patients with Multiple Sclerosis.