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Findings from Solomon Tesfaye and colleagues’ OPTION-DM trial1 are a useful but intellectually
challenging contribution to understanding drug treatment of painful neuropathy. It
reiterates a popular expert opinion that gabapentin must be given three times daily
and “requires a long titration period of up to 2 months to avoid toxicity”.1 Gabapentin
and pregabalin have similar elimination half-lives, via renal excretion. Twice daily
administration gave pregabalin a marketing advantage when the patent on gabapentin
expired.
Solomon-tesfaye