Comparison the effects of gabapentin and oxazepam on sleep quality, anxiety, and pain in unstable angina patients admitted to coronary care unit of Hazrat Rasool Akram Hospital


1 Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran

2 Department of Cardiology, Rasool E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran


Background: This study aimed to compare the efficacy of gabapentin and oxazepam on sleep quality, the severity of anxiety, and pain level in patients admitted to the coronary care unit (CCU). Materials and Methods: This double-blind randomized clinical trial was done on the patients with unstable angina (UA) admitted to the CCU of Hazrat Rasool Akram Hospital in Tehran. A total of 56 patients were entered the study and randomly divided into two groups of 26. The first group was given a gabapentin capsule at a dose of 300–1200 mg/day, and the second group was given 10–20 mg of oxazepam tablets per day until hospitalization in the CCU. On the first and 4th days of hospitalization, Groningen sleep quality score (GSQS), Beck Anxiety Inventory, and severity of pain experienced by Visual Analogue Scale were recorded, and the mean frequency of chest pains was calculated in 24 h during the first 4 days. The amount of drug (morphine) prescription in CCU also compared between the two groups. Results: There was no significant difference in GSQS scores between both groups. The mean score of Beck's anxiety scale did not differ significantly between the two groups. However, the incidence of chest pain was significantly lower in the gabapentin-receiving group than in the oxazepam-receiving group (<0.001). The days that the patients experienced chest pain were significantly less in the gabapentin-receiving group than in the oxazepam-receiving group (<0.001). Conclusion: The results of our study showed that gabapentin compared to oxazepam could significantly reduce chest pain in patients with UA.


Gallagher R, McKinley S. Stressors and anxiety in patients undergoing coronary artery bypass surgery. Am J Crit Care 2007;16:248-57.  Back to cited text no. 1
Davari M, Amani B, Amani B, Khanijahani A, Akbarzadeh A, Shabestan R. Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: A systematic review and meta-analysis. Korean J Pain 2020;33:3-12.  Back to cited text no. 2
Beyranvand, M, Kolahi, A, Ghafelebashi S. Charactristics and final diagnosis of patients with primary diagnosis of acute coronary syndrome. JBUMS 2008;10:76-82.  Back to cited text no. 3
Moeini M, Khadibi M, Bekhradi R, Mahmoudian SA, Nazari F. Effect of aromatherapy on the quality of sleep in ischemic heart disease patients hospitalized in intensive care units of heart hospitals of the Isfahan University of Medical Sciences. Iran J Nurs Midwifery Res 2010;15:234-9.  Back to cited text no. 4
Sadr Bafghi SM, Rafie M, Modares Mosadegh M, Ahmadiah MH, ZandiKarimi F, Aghili K. Clinical and paraclinical characteristics of patients with unstable Anyina hospitalized at Ccu. Tehran Univ Med J 2003;61:293-9.  Back to cited text no. 5
Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001;104:2746-53.  Back to cited text no. 6
Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J, Manolio T, et al. Heart disease and stroke statistics – 2006 update: A report from the American heart association statistics committee and stroke statistics subcommittee. Circulation 2006;113:e85-151.  Back to cited text no. 7
Louis M, Kowalski SD. Use of aromatherapy with hospice patients to decrease pain, anxiety, and depression and to promote an increased sense of well-being. Am J Hosp Palliat Care 2002;19:381-6.  Back to cited text no. 8
Huffman JC, Smith FA, Blais MA, Januzzi JL, Fricchione GL. Anxiety, independent of depressive symptoms, is associated with in-hospital cardiac complications after acute myocardial infarction. J Psychosom Res 2008;65:557-63.  Back to cited text no. 9
Martin CR, Lewin RJ, Thompson DR. A confirmatory factor analysis of the hospital anxiety and depression scale in coronary care patients following acute myocardial infarction. Psychiatry Res 2003;120:85-94.  Back to cited text no. 10
Lane D, Carroll D, Ring C, Beevers DG, Lip GY. The prevalence and persistence of depression and anxiety following myocardial infarction. Br J Health Psychol 2002;7:11-21.  Back to cited text no. 11
An K, De Jong MJ, Riegel BJ, McKinley S, Garvin BJ, Doering LV, et al. A cross-sectional examination of changes in anxiety early after acute myocardial infarction. Heart Lung 2004;33:75-82.  Back to cited text no. 12
Lopes Jde L, Nogueira-Martins LA, Gonçalves MA, de Barros AL. Comparing levels of anxiety during bed and shower baths in patients with acute myocardial infarction. Rev Lat Am Enfermagem 2010;18:217-23.  Back to cited text no. 13
Frazier SK, Moser DK, O'Brien JL, Garvin BJ, An K, Macko M. Management of anxiety after acute myocardial infarction. Heart Lung 2002;31:411-20.  Back to cited text no. 14
Leslie DL, Zhang Y, Holford TR, Bogardus ST, Leo-Summers LS, Inouye SK. Premature death associated with delirium at 1-year follow-up. Arch Intern Med 2005;165:1657-62.  Back to cited text no. 15
Thelen J, Zvonarev V, Lam S, Burkhardt C, Lynch S, Bruce J. Polypharmacy in multiple sclerosis: current knowledge and future directions. Mo Med 2021;118:239-45.  Back to cited text no. 16
Huffman JC, Stern TA. The use of benzodiazepines in the treatment of chest pain: A review of the literature. J Emerg Med 2003;25:427-37.  Back to cited text no. 17
Longo LP, Johnson B. Addiction: Part I. Benzodiazepines – Side effects, abuse risk and alternatives. Am Fam Physician 2000;61:2121-8.  Back to cited text no. 18
Snyder MJ, Gibbs LM, Lindsay TJ. Treating painful diabetic peripheral neuropathy: An update. Am Fam Physician 2016;94:227-34.  Back to cited text no. 19
Fassoulaki A, Patris K, Sarantopoulos C, Hogan Q. The analgesic effect of gabapentin and mexiletine after breast surgery for cancer. Anesth Analg 2002;95:985-91.  Back to cited text no. 20
Sihoe AD, Lee TW, Wan IY, Thung KH, Yim AP. The use of gabapentin for post-operative and post-traumatic pain in thoracic surgery patients. Eur J Cardiothorac Surg 2006;29:795-9.  Back to cited text no. 21
Ucak A, Onan B, Sen H, Selcuk I, Turan A, Yilmaz AT. The effects of gabapentin on acute and chronic postoperative pain after coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2011;25:824-9.  Back to cited text no. 22
Foldvary-Schaefer N, De Leon Sanchez I, Karafa M, Mascha E, Dinner D, Morris HH. Gabapentin increases slow-wave sleep in normal adults. Epilepsia 2002;43:1493-7.  Back to cited text no. 23
Hossein Kaviani H, Mousavi AS. Psychometric properties of the persian version of beck anxiety inventory (BAI). Tehran Univ Med J 2008;66:136-40.  Back to cited text no. 24
Jafarian S, Gorouhi F, Taghva A, Lotfi J. High-altitude sleep disturbance: Results of the Groningen Sleep Quality Questionnaire survey. Sleep Med 2008;9:446-9.  Back to cited text no. 25
Rezvani Amin M, Siratinayer M, Abadi A, Moradyan T. Correlation between visual analogue scale and short form of McGill questionnaire in patients with chronic low back pain. Qom Univ Med Sci J 2012;6:31-4.  Back to cited text no. 26
Cooper TE, Derry S, Wiffen PJ, Moore RA. Gabapentin for fibromyalgia pain in adults. Cochrane Database Syst Rev 2017;1:CD012188.  Back to cited text no. 27
Talebi, Houshang, Afsane Norouzi, Shahin Fateh, Farzane Alamshahi, and Armin Fateh. “Effect of preoperative gabapentin in reducing pain after laparoscopic cholecystectomy. JOURNAL OF ANESTHESIOLOGY AND PAIN (PERSIAN) 2012; 1: 16-21.  Back to cited text no. 28
Han C, Li XD, Jiang HQ, Ma JX, Ma XL. The use of gabapentin in the management of postoperative pain after total knee arthroplasty: A PRISMA-compliant meta-analysis of randomized controlled trials. Medicine (Baltimore) 2016;95:e3883.  Back to cited text no. 29
North JM, Hong KS, Rauck RL. The Effect of a Novel form of Extended-Release Gabapentin on Pain and Sleep in Fibromyalgia Subjects: An Open-Label Pilot Study. Pain Practice. 2016;16:720-9.  Back to cited text no. 30
Megna JL, Devitt PJ, Sauro MD, Dewan MJ. Gabapentins effect on agitation in severely and persistently mentally III patients. Ann Pharmacother 2002;36:12-6.  Back to cited text no. 31