Articles: neuralgia.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multicentre, placebo-controlled trial of flexible- and fixed-dose regimens.
Pregabalin binds with high affinity to the alpha2-delta subunit protein of voltage-gated calcium channels and, thereby, reduces release of excitatory neurotransmitters. This 12-week randomised, double-blind, multicentre, placebo-controlled, parallel-group study evaluated the efficacy and safety of pregabalin in patients with chronic postherpetic neuralgia (PHN) or painful diabetic peripheral neuropathy (DPN). Patients were randomised to placebo (n=65) or to one of two pregabalin regimens: a flexible schedule of 150, 300, 450, and 600 mg/day with weekly dose escalation based on patients' individual responses and tolerability (n=141) or a fixed schedule of 300 mg/day for 1 week followed by 600 mg/day for 11 weeks (n=132). ⋯ The most common adverse events (AEs) for pregabalin-treated patients were dizziness, peripheral oedema, weight gain (not affecting diabetes control), and somnolence. These results are consistent with previous studies' demonstrating pregabalin's efficacy, tolerability, and safety for treatment of chronic neuropathic pain associated with DPN or PHN. Pregabalin dosing aimed at optimal balance of efficacy and tolerability provides significant pain relief and may reduce risks for AEs and therapy discontinuation.
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Acta Anaesthesiol Taiwan · Jun 2005
Randomized Controlled Trial Clinical TrialStarting dose of gabapentin for patients with post-herpetic neuralgia--a dose-response study.
Gabapentin has been shown to provide pain relief for post-herpetic neuralgia at dosage of 1200 to 2400 mg/day. However, the initial dosing strategy has not been thoroughly investigated. The purpose of this study was to establish the initial dosing strategy in the treatment of the gabapentin-naive patients with post-herpetic neuralgia. ⋯ This study shows that elderly gabapentin-naive subjects no matter whether receiving 200, 400 or 600 mg/day of gabapentin benefited a moderate pain relief with minimal side effects at the first three days of treatment. Since starting with a minimal dose of 200 mg/day did not offer a better reduction of side effects, we suggest that 600 mg/day gabapentin could be a safe and effective starting dose for patients with post-herpetic neuralgia.
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Randomized Controlled Trial Clinical Trial
Effectiveness of frequency-modulated electromagnetic neural stimulation in the treatment of painful diabetic neuropathy.
The largely unsatisfactory results reported for the pharmacological treatment of diabetic neuropathy has spurred the search for alternative therapies. The aim of this study was to evaluate the efficacy of frequency-modulated electromagnetic neural stimulation (FREMS) as a novel treatment for painful diabetic neuropathy. ⋯ FREMS is a safe and effective therapy for neuropathic pain in patients with diabetes and is able to modify some parameters of peripheral nerve function.
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Randomized Controlled Trial Clinical Trial
Morphine, gabapentin, or their combination for neuropathic pain.
The available drugs to treat neuropathic pain have incomplete efficacy and dose-limiting adverse effects. We compared the efficacy of a combination of gabapentin and morphine with that of each as a single agent in patients with painful diabetic neuropathy or postherpetic neuralgia. ⋯ Gabapentin and morphine combined achieved better analgesia at lower doses of each drug than either as a single agent, with constipation, sedation, and dry mouth as the most frequent adverse effects.
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Randomized Controlled Trial Clinical Trial
Differential effects of neuropathic analgesics on wind-up-like pain and somatosensory function in healthy volunteers.
To investigate the effects of gabapentin, carbamazepine, and amitriptyline on temporal summation, simple nociceptive pain, and innocuous touch sensation in healthy volunteers. ⋯ We have shown that gabapentin, carbamazepine, and amitriptyline, three pharmacologically different drugs, have distinct and quantifiable effects on somatosensory pathways in healthy volunteers. These findings provide a link between pharmacology of the study drugs and clinical effectiveness. The effects of gabapentin and carbamazepine on temporal summation pain show that these drugs can block centrally amplified wind-up pain in the absence of a neuropathic disorder.