Are Gabapentin or Pregabalin Effective for Post-Polio Neurological Damage?

Question: Are gabapentin or pregabalin effective medications for post-polio neurological damage, the type of damage that leads to leg and hand muscle cramps?

Answer: Gabapentin and pregabalin are only approved for control of seizures and fibromyalgia (in the case of pregabalin). There are no studies supporting their effective-ness for leg cramps in post-polio survivors or others. Gabapentin is the most widely prescribed and used off-label drug for chronic pain syndromes of all sorts. If these drugs are used for leg cramps, they should be evaluated carefully on an individual basis relative to their effectiveness and the optimal minimally effective dose. For post-polio survivors with leg cramps, a thorough history and exam should be done regarding the most likely cause(s) of the cramps. Tight muscles that can be treated by stretching exercises are the most common contributing factor, followed by overuse/misuse of the leg muscles. Metabolic imbalances of calcium and magnesium are also common. None of these common causes are likely to respond to treatment with gabapentin or pregabalin.

Post-Polio Health (Vol. 29, No. 4, Fall 2013)