Gabapentin was first used as a drug for the treatment of epilepsy, but it has gradually been widely used after researchers found that it has surprising effects on neuropathic pain. The following is a summary of its treatment of neuropathic pain: 1. Pharmacological mechanism: Inhibition of presynaptic membrane nociceptive substance release: Gabapentin binds to the α2δ subunit of the presynaptic membrane calcium channel, inhibiting calcium inward flow and reducing nociceptive substance release; Inhibition of postsynaptic membrane neuronal excitation: Gabapentin concentration-dependent inhibition of NMDA receptor activity, inhibiting excitatory postsynaptic potential generation and neuronal It promotes the production of GABA: gabapentin enhances the activity of glutamate decarboxylase (GAD), which increases the production of GABA and has an inhibitory effect on neuronal excitability. 2.How to use Use: Start with 300 mg daily and gradually increase the dosage. Until the pain is well controlled or intolerable adverse effects occur. Generally, it can be maintained at a dose of 1800 mg per day. Day 1: 300 mg (one tablet at night) at bedtime; Day 2: 600 mg in two divided doses (one tablet in the morning and one tablet in the evening); Day 3: 900 mg in three divided doses (one tablet in the morning, one tablet in the afternoon, and one tablet in the evening); Day 4: 1200 mg in three divided doses; then maintain the dose and gradually increase the dose at the discretion of the physician according to the patient’s pain control. The FDA recommends a target dose of 1800 mg per day for gabapentin for postherpetic neuralgia. The maximum dose is 3600 mg per day. The effective dose should be determined based on patient efficacy and tolerability to achieve individualized dosing. Maintenance doses are treated for 1-2 weeks to assess their effectiveness. Guidelines recommend more than 4 weeks. Discontinuation should be based on effective, stable treatment effect and a gradual reduction in dose. 3, toxic side effects common drowsiness (15.2%), dizziness (10.9%), especially drip periodically, rare peripheral edema, ataxia, etc.. Contraindications: patients with acute pancreatitis. It is best not to combine with antacids and to take antacids only after 2h. 4. Tips for use: (1) Most patients add up to 900mg/day to have a significant effect, at least 1-2 weeks to have a significant effect, the general course of treatment in 4-8 weeks. (2) gabapentin side effects are tolerated with individual differences, the dose of each drug drug used should be adjusted in accordance with the observation of efficacy and the appearance of adverse reactions and patient compliance. (3) Appropriate control of the titration rate can reduce the incidence of adverse reactions such as dizziness and drowsiness. 5, precautions: It should be noted that: the increase or decrease of the drug is very delicate, the patient is best to change the drug dose under the guidance of a pain specialist, in order to avoid drug dose deficiency or drug rebound effect (refers to a long time use of a drug,, and suddenly stop the drug after the original symptoms relapse and intensify the phenomenon. A rebound can cause pain that is already well controlled to reappear and the original control dose does not control the pain.