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Neurontin

[Gabapentin]


Warnings & Precautions
WARNINGS

Neuropsychiatric Adverse Events— Pediatric Patients 3-12 years of age

Gabapentin use in pediatric patients with epilepsy 3– 12 years of age is associated with the occurrence of central nervous system related adverse events. The most significant of these can be classified into the following categories:

Text Continues Below



1) emotional lability (primarily behavioral problems),

2) hostility, including aggressive behaviors,

3) thought disorder, including concentration problems and change in school performance, and

4) hyperkinesia (primarily restlessness and hyperactivity). Among the gabapentin-treated patients, most of the events were mild to moderate in intensity.

In controlled trials in pediatric patients 3– 12 years of age the incidence of these adverse events was: emotional lability 6% (gabapentin-treated patients) vs 1.3% (placebo-treated patients); hostility 5.2% vs 1.3%; hyperkinesia 4.7% vs 2.9%; and thought disorder 1.7% vs 0%. One of these events, a report of hostility, was considered serious. Discontinuation of gabapentin treatment occurred in 1.3% of patients reporting emotional lability and hyperkinesia and 0.9% of gabapentin-treated patients reporting hostility and thought disorder. One placebo-treated patient (0.4%) withdrew due to emotional lability.

Withdrawal Precipitated Seizure, Status Epilepticus
Antiepileptic drugs should not be abruptly discontinued because of the possibility of increasing seizure frequency.

In the placebo-controlled studies in patients >12 years of age, the incidence of status epilepticus in patients receiving Neurontin ® was 0.6% (3 of 543) versus 0.5% in patients receiving placebo (2 of 378). Among the 2074 patients >12 years of age treated with Neurontin ® across all studies (controlled and uncontrolled) 31 (1.5%) had status epilepticus. Of these, 14 patients had no prior history of status epilepticus either before treatment or while on other medications. Because adequate historical data are not available, it is impossible to say whether or not treatment with Neurontin ® is associated with a higher or lower rate of status epilepticus than would be expected to occur in a similar population not treated with Neurontin ® .

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