Gabapentin as Adjunctive Therapy in Neonatal Opioid Withdrawal Syndrome: A Case Series

Abstract

OBJECTIVE We describe a single center experience with gabapentin as adjunctive therapy in infants with neonatal opioid withdrawal syndrome (NOWS). METHODS We performed a retrospective chart review of infants receiving gabapentin for NOWS. Data points collected included patient’s sex, gestational age, maternal opioid exposure, NOWS medication dosing and length of therapy, number of failed wean attempts, time to successful morphine wean and duration of morphine wean, length of stay in the neonatal intensive care unit (NICU), and NOWS medications at discharge. RESULTS Six infants received gabapentin as adjunctive treatment for NOWS. All infants failed 2–4 morphine weans before initiation of gabapentin despite the addition of clonidine. All infants that received gabapentin were successfully weaned off morphine. The time to wean off morphine after gabapentin initiation varied from 4–35 days. Maximum gabapentin doses ranged from 15 – 42.7 mg/kg/day. Five infants were discharged from the NICU on gabapentin. CONCLUSIONS Gabapentin appeared to facilitate successful morphine weans in six patients with NOWS who were previously unable to wean despite the initiation of clonidine.