Both the pathogenetic interpretation and treatment of phenobarbital-induced rheumatism are uncertain. The reflex sympathetic dystrophy syndrome which complicates antiepileptic drug therapy is a problem for rheumatologists. The aim of our study was to test the effect of gabapentin as an additional therapy in patients suffering from phenobarbital-induced shoulder-hand syndrome when these patients were treated with gabapentin instead of receiving phenobarbital only. After a 3-month observation period, the pain and the movement range from the shoulder to the wrist and to the hand improved more than in the control group using acetaminophen. Further studies are required to confirm this observation.