Ann Intern Med

Gabapentin vs. duloxetine: Fall risk in older adults

January 8, 2025

Study details: This new user, active comparator study used a target trial emulation framework to analyze MarketScan commercial claims data from January 2014 to December 2021. The cohort included 57,086 adults ≥65 years with diabetic neuropathy, postherpetic neuralgia, or fibromyalgia who initiated gabapentin (n = 52,152) or duloxetine (n = 4,934).

Results: Gabapentin users had lower weighted cumulative incidence rates of fall-related visits per 1,000 person-years at 30, 90, and 180 days (103.60, 90.44, and 84.44, respectively) compared with duloxetine users (203.43, 177.73, and 158.21, respectively). The hazard ratio for falls at six months was 0.52 (95% confidence interval 0.43-0.64) for gabapentin users. No significant difference was observed in the hazards of severe falls between the two groups.

Clinical impact: Gabapentin may be a safer option than duloxetine regarding fall risk in older adults with neuropathic pain. Clinicians may want to consider these results when discussing treatment options with patients, particularly those at higher risk for falls.

Source:

Chaitoff A, et al. (2025, January 7). Ann Intern Med. Assessing the Risk for Falls in Older Adults After Initiating Gabapentin Versus Duloxetine. https://pubmed.ncbi.nlm.nih.gov/39761587/