Analgesic and Sedative Effects of Melatonin in Temporomandibular Disorders: A Double-Blind, Randomized, Parallel-Group, Placebo-Controlled Study

Vidor, Liliane Pinto; Torres, Iraci Lucena da Silva; Souza, Izabel Cristina Custodio de; Fregni, Felipe; Caumo, Wolnei

doi:10.1016/j.jpainsymman.2012.08.019

Cited by 62 publications

(90 citation statements)

References 40 publications

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“…Melatonin’s effect on pain was demonstrated by the VAS, FIQ and PPT. These findings corroborate evidence of experimental studies [8] and previous randomized clinical trials on acute pain [10,14] and chronic pain such as fibromyalgia [5,6], temporomandibular disorders [15], endometriosis [16] and a dose–response study with healthy subjects [26]. The highly lipid-soluble nature of melatonin allows it to easily penetrate the blood–brain barrier.…”

Section: Discussionsupporting

confidence: 86%

“…Melatonin’s effect on pain has been demonstrated in animals for inflammatory [8] and neuropathic pain [11-13], as well in acute [10,14] and chronic pain in humans [15,16]. In addition, there is some clinical evidence of melatonin’s effect on FM [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Noradrenergic projections from the locus coeruleus produce similar effects [25]. Together, this evidence justifies assessing the effect of melatonin in the descending modulatory pain systems, alone or combined with classic therapeutic agents such as amitriptyline, as it has been demonstrated that melatonin increases the pain threshold in healthy subjects [26], improves sleep quality [15] and modulates systems involved in pain, such as the GABAergic and opioidergic systems [12,27,28]. …”

Section: Introductionmentioning

confidence: 99%

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Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia: a phase II, randomized, double-dummy, controlled trial

Zanette

Vercelino

Laste

et al. 2014

BMC Pharmacol Toxicol

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102

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BackgroundCentral disinhibition is a mechanism involved in the physiopathology of fibromyalgia. Melatonin can improve sleep quality, pain and pain threshold. We hypothesized that treatment with melatonin alone or in combination with amitriptyline would be superior to amitriptyline alone in modifying the endogenous pain-modulating system (PMS) as quantified by conditional pain modulation (CPM), and this change in CPM could be associated with serum brain-derived neurotrophic factor (BDNF). We also tested whether melatonin improves the clinical symptoms of pain, pain threshold and sleep quality.MethodsSixty-three females, aged 18 to 65, were randomized to receive bedtime amitriptyline (25 mg) (n = 21), melatonin (10 mg) (n = 21) or melatonin (10 mg) + amitriptyline (25 mg) (n = 21) for a period of six weeks. The descending PMS was assessed with the CPM-TASK. It was assessed the pain score on the Visual Analog Scale (VAS 0-100 mm), the score on Fibromyalgia Impact Questionnaire (FIQ), heat pain threshold (HPT), sleep quality and BDNF serum. Delta values (post- minus pre-treatment) were used to compare the treatment effect. The outcomes variables were collected before, one and six weeks after initiating treatment.ResultsMelatonin alone or in combination with amitriptyline reduced significantly pain on the VAS compared with amitriptyline alone (P < 0.01). The delta values on the VAS scores were-12.85 (19.93),-17.37 (18.69) and-20.93 (12.23) in the amitriptyline, melatonin and melatonin+amitriptyline groups, respectively. Melatonin alone and in combination increased the inhibitory PMS as assessed by the Numerical Pain Scale [NPS(0-10)] reduction during the CPM-TASK:-2.4 (2.04) melatonin + amitriptyline,-2.65 (1.68) melatonin, and-1.04 (2.06) amitriptyline, (P < 0.05). Melatonin + amitriptyline treated displayed better results than melatonin and amitriptyline alone in terms of FIQ and PPT improvement (P < 0.05, fort both).ConclusionMelatonin increased the inhibitory endogenous pain-modulating system as assessed by the reduction on NPS(0-10) during the CPM-TASK. Melatonin alone or associated with amitriptyline was better than amitriptyline alone in improving pain on the VAS, whereas its association with amitriptyline produced only marginal additional clinical effects on FIQ and PPT.Trial registrationCurrent controlled trail is registered at clinical trials.gov upon under number NCT02041455. Registered January 16, 2014.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia: a phase II, randomized, double-dummy, controlled trial

Zanette

Vercelino

Laste

et al. 2014

BMC Pharmacol Toxicol

Self Cite

102

View full text Add to dashboard Cite

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“…Additionally, the tumor necrosis factor (TNF) system [101] as well as the hypothalamic-pituitary-adrenal-axis [102] are influenced by sleep and pain. Melatonin, which is an essential regulator of the circadian rhythm, also interacts with pain [103,104].…”

Section: Discussionmentioning

confidence: 99%

The effect of sleep deprivation on pain perception in healthy subjects: a meta-analysis

et al. 2015

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“…Opioids administered for primary pain disorders have low long-term efficacy, a poor safety profile, and commonly a worse clinical outcome [133,134,135,136,137,138,139]. Thus, opioids should not be administered to pediatric patients with primary pain disorders [43], i.e., chronic pain defined that extends beyond the expected time of healing and hence lacks the acute warning function of physiological nociception.…”

Section: Medicationsmentioning

confidence: 99%

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

et al. 2016

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Primary pain disorders (formerly “functional pain syndromes”) are common, under-diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics: primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain. A significant number of children with repeated acute nociceptive pain episodes develop chronic pain in addition to or as a result of their underlying medical condition “chronic-on-acute pain.” We provide description of the structure and process of our interdisciplinary, rehabilitative pain clinic in Minneapolis, Minnesota, USA with accompanying data in the treatment of chronic pain symptoms that persist beyond the expected time of healing. An interdisciplinary approach combining (1) rehabilitation; (2) integrative medicine/active mind-body techniques; (3) psychology; and (4) normalizing daily school attendance, sports, social life and sleep will be presented. As a result of restored function, pain improves and commonly resolves. Opioids are not indicated for primary pain disorders, and other medications, with few exceptions, are usually not first-line therapy.

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Analgesic and Sedative Effects of Melatonin in Temporomandibular Disorders: A Double-Blind, Randomized, Parallel-Group, Placebo-Controlled Study

Cited by 62 publications

References 40 publications

Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia: a phase II, randomized, double-dummy, controlled trial

Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia: a phase II, randomized, double-dummy, controlled trial

The effect of sleep deprivation on pain perception in healthy subjects: a meta-analysis

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

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