Gabapentin for Headache in Aneurysmal Subarachnoid Hemorrhage
Gabapentin for Headache in Aneurysmal Subarachnoid Hemorrhage
The purpose of this study is to see how much gabapentin will reduce headaches associated with
 subarachnoid hemorrhage (SAH) and to reduce the amount of narcotic pain medication
 prescribed.
The investigators plan to use gabapentin (GBP), an FDA approved non-narcotic pain medication
 for neuropathic pain, which is also an alpha-2-delta (A2DR) receptor analogue to reduce the
 pain and decrease the need for narcotics in patients with aneurysmal subarachnoid hemorrhage
 (aSAH). GBP has been shown to decrease neuropathic and non-neuropathic pain in a variety of
 perioperative and postoperative conditions. A2DR affinity also has some neuroprotective
 effect in animal data. The investigators plan to conduct a prospective, double-blinded,
 randomized trial to further assess GBP-associated reductions in narcotic use and pain scores
 compared to the non-GBP (placebo) arm. To accomplish this aim, the investigators plan to
 randomize 20 aSAH patients with headache to either GBP and standard of care pain treatment
 versus placebo and standard of care treatment.
Inclusion Criteria:

 1. 18 years of age or older

 2. Have aneurysmal subarachnoid hemorrhage (aSAH) diagnosed by CT scan of the brain
 and/or angiogram evidence of intracranial aneurysm (CTA or digital subtraction
 angiogram or MRA)

 3. Have symptomatic headache

 4. Able to swallow and verbalize pain score

 5. No known allergy to gabapentin or fentanyl

 6. Numeric pain score ≥ 5

 7. Ability to provide written personal consent

 Exclusion Criteria:

 1. Gabapentin use prior to SAH admission

 2. Renal failure with creatinine clearance less than 30 mL/min

 3. Unable to receive standard of care pain medications

 4. Pregnant or breastfeeding patients

 5. History of severe depression defined by the Diagnostic and Statistical Manual of
 Mental Disorders, 4th Edition, Text Revision (DSM IV)