Topiramate in chronic lumbar radicular pain
| Autor: | Vesta Salehi, Suzan Khoromi, Suzan Parada, Athos Patsalides, Jennifer M. Meegan, Mitchell B. Max |
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| Rok vydání: | 2005 |
| Předmět: |
Active placebo
Topiramate Adult Male medicine.medical_treatment Fructose Drug Administration Schedule Ion Channels Placebos Lumbar Double-Blind Method Medicine Humans Radiculopathy Aged Analgesics Lumbar Nerve Cross-Over Studies Dose-Response Relationship Drug business.industry Middle Aged medicine.disease Crossover study Anesthesiology and Pain Medicine Anticonvulsant Diphenhydramine Treatment Outcome Neurology Receptors Glutamate Radicular pain Anesthesia Neuropathic pain Chronic Disease Patient Compliance Anticonvulsants Female Neurology (clinical) business Low Back Pain Intervertebral Disc Displacement medicine.drug |
| Zdroj: | The journal of pain. 6(12) |
| ISSN: | 1526-5900 |
| Popis: | Chronic lumbar radicular pain is the most common neuropathic pain syndrome. This was a double-blind, randomized, 2-period crossover trial of topiramate (50 to 400 mg) and diphenhydramine (6.25 to 50 mg) as active placebo to assess the efficacy of topiramate. Each period consisted of a 4-week escalation, a 2-week maintenance at the highest tolerated dose, and a 2-week taper. Main outcome was the mean daily leg pain score on a 0 to 10 scale during the maintenance period. Global pain relief was assessed on a 6-level category scale. In the 29 of 42 patients who completed the study, topiramate reduced leg pain by a mean of 19% (P = .065). Global pain relief scores were significantly better on topiramate (P.005). Mean doses were topiramate 200 mg and diphenhydramine 40 mg. We concluded that topiramate treatment might reduce chronic sciatica in some patients but causes frequent side effects and dropouts. We would not recommend topiramate unless studies of alternative regimens showed a better therapeutic ratio.The anticonvulsant topiramate might reduce chronic lumbar nerve root pain through effects such as blockade of voltage-gated sodium channels and AMPA/kainite glutamate receptors, modulation of voltage-gated calcium channels, and gamma-aminobutyric acid agonist-like effects. |
| Databáze: | OpenAIRE |
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