Which drug should be used first for chronic sciatica?

When two drugs were compared, one delivered better pain relief with fewer side effects

Gabapentin should be the first-line treatment for chronic sciatica over pregabalin because it delivers greater pain relief and few adverse events, according to an Australian study.

Among 18 adults taking gabapentin for eight weeks followed by eight weeks with pregabalin, or vice-versa, gabapentin provided superior reduction in pain intensity based on a 10-point visual scale, the randomised, double-blind study found.

The mean pain score dropped from 7.54 to 5.82 for gabapentin, compared with a reduction in mean pain from 7.33 to 6.38 for pregabalin, the Townsville Hospital study authors reported in JAMA Neurology.

Furthermore, gabapentin was responsible for only 19% of the adverse events experienced by the participants.

Overall 67% reported adverse events including drowsiness, dizziness or nausea.

Adverse events were also more frequent when