Efficacy and Safety of Gabapentin vs. Carbamazepine in the Treatment of Trigeminal Neuralgia: A Meta-Analysis.

To evaluate the safety and efficacy of gabapentin in comparison with carbamazepine in the treatment of trigeminal neuralgia, a meta-analysis of randomized controlled trials was performed. Two reviewers independently selected studies, assessed study quality, and extracted data. Sixteen randomized controlled trials that included 1,331 patients were assessed. The meta-analysis showed that the total effective rate of gabapentin therapy group was similar with carbamazepine therapy group (OR = 1.600, 95% CI 1.185, 2.161, P = 0.002). While the effective rate of gabapentin therapy for 4 weeks was higher than that of carbamazepine therapy (OR = 1.495, 95% CI 1.061, 2.107, P = 0.022, heterogeneity: x2 = 7.12, P = 0.625, I2 = 0.0%), the life satisfaction improvement is also better in the gabapentin therapy group after a 4-week treatment (SMD = 0.966, 95% CI 0.583, 1.348, P < 0.001). Furthermore, our meta-analysis suggested that the adverse reaction rate of gabapentin therapy group was significantly lower than that of carbamazepine therapy group (OR = 0.312, 95% CI 0.240, 0.407, P < 0.001). In conclusion, present trials comparing gabapentin with carbamazepine are all poor in terms of methodological quality. Based on the available evidence, it is not possible to draw conclusions regarding the efficacy and side effects of gabapentin being superior to carbamazepine.

Blood Pressure and the Risk of Alzheimer's Disease: Is There a Link?

Alzheimer disease is one of the most common neurodegenerative disorder, and the incidence is increasing. Many epidemiologic studies have considered the association between blood pressure and Alzheimer disease, yet the relationship is still controversial. The objective of this study was to validate whether or not blood pressure is indeed associated with AD. We compared different prospective studies and ultimately found that it is also a controversial issue. Large prospective double-blinded and placebo-controlled studies conducted with the use of standardized outcome measures in different levels are necessary to assess the association of blood pressure and Alzheimer disease.