OBJECTIVES: Gabapentin is generally prescribed for nerve pain reduction and seizure control. Some pre-clinical studies found that it may help in functional recovery after a stroke. This study determines the effect of gabapentin on functional recovery measures such as mobility and GAIT abnormality among stroke survivors.

METHODS: A retrospective cohort analysis of adult (age >18 years) stroke survivors in 2021 and 2022 followed for a minimum of 90 days. Data from the electronic health records of 75 healthcare organizations were included. Stroke was identified using ICD-10 codes and RxNorm drug class was used to identify gabapentin use. Stroke survivors were classified into gabapentin users (N = 75,036) and non-users (N=329,503). One-to-one propensity score matching of gabapentin users and non-users consisted of age, sex, race and ethnicity, surgery, pain, epilepsy and seizures, diseases of the following systems: (circulatory; endocrine, nutritional, and metabolic; musculoskeletal and connective tissues; nervous; digestive; genitourinary; respiratory; mental health, behavioral and neurodevelopmental; skin and subcutaneous tissue; injury and poisoning). The primary outcome, identified with the healthcare common procedure coding System and ICD-10 codes, was limited functioning and was based on reduced mobility or walking & moving around functional limitation or abnormal gait measured after at least 90 days of gabapentin use. All statistical analyses were performed on the TrinetX online platform.

RESULTS: Overall, 18.5% of stroke survivors used gabapentin after the stroke. Of the 73,779 propensity scores-matched gabapentin users and non-users, a higher percentage of gabapentin users had limited functioning (9.7%) compared to non-users (11.9% vs. 9.7%). The risk ratio was 1.17 (95% CI = 1.13, 1.21) and p< 0.001.

CONCLUSIONS: One in five stroke survivors used gabapentin. Gabapentin use was associated with limited functioning. Future studies with prospective cohorts are needed to confirm these findings.