Drug therapy for chronic idiopathic axonal polyneuropathy

Vrancken, AFJE; Schaik, IN van; Hughes, R. A. C.; Notermans, N. C.

doi:10.1002/14651858.cd003456

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…4 No clinical studies have been reported concerning the treatment of neuropathic pain in CIAP patients. 5 Anticonvulsants and antidepressants are the first choice treatments for the reduction of neuropathic pain. 6 Amitriptyline is frequently the drug of choice for diabetic neuropathic pain.…”

Section: Introductionmentioning

confidence: 99%

High Doses of Topical Amitriptyline in Neuropathic Pain: Two Cases and Literature Review

Kopsky¹,

Hesselink²

2011

Pain Practice

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Severe chronic neuropathic pain is a challenge to treat, and due to adverse effects of classical oral medication, optimal and effective dose levels are difficult to reach. Therefore, administration of topical analgesics might be an option, due to reduced adverse effects, and increased patient compliance. The aim of this article is to describe two cases treated effectively with topical amitriptyline 5% and 10%, the highest dosage described to date. The first patient was a 39-year-old man, suffering from severe intractable neuropathic pain in feet and hands, due to diabetes mellitus type II (DM-II). After application of amitriptyline 5% the patient experienced a complete relieve only in the hands, whereas after application of amitriptyline 10%, a total reduction of pain occurred within 20 minutes, lasting the whole day. The second patient was a 57-year-old man, suffering for 10 years from progressive sensory disturbances in both feet and increasing pain due to chronic idiopathic axonal polyneuropathy (CIAP). Amitriptyline 5% cream reduced pain in the toes nearly completely, but this was not the case in the heels. Amitriptyline 10% reduced pain in the feet, however, systemic adverse effects occurred, mainly drowsiness. The patient decided to stop topical treatment because of these adverse effects. These two cases suggest an analgesic dose-response effect of topical amitriptyline in painful neuropathy. Systemic adverse effects should be taken into account.

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Section: Introductionmentioning

confidence: 99%

High Doses of Topical Amitriptyline in Neuropathic Pain: Two Cases and Literature Review

Kopsky¹,

Hesselink²

2011

Pain Practice

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Drug therapy for chronic idiopathic axonal polyneuropathy

Warendorf

Vrancken

Schaik

et al. 2017

Cochrane Database of Systematic Reviews

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Cochrane Database of Systematic Reviews Data collection and analysis Two review authors independently reviewed the results of the literature search and extracted details of trial methodology and outcome data of all potentially relevant trials. Main results We identified 39 studies and assessed them for possible inclusion in the review, but we excluded all of them because of insu icient quality or lack of relevance. We summarised evidence from non-randomised studies in the Discussion. Authors' conclusions Even though CIAP has been clearly described and delineated, no adequate randomised or quasi-randomised controlled clinical treatment trials have been performed. In their absence there is no proven e icacious drug therapy.

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Drug therapy for chronic idiopathic axonal polyneuropathy

Cited by 2 publications

References 24 publications

High Doses of Topical Amitriptyline in Neuropathic Pain: Two Cases and Literature Review

High Doses of Topical Amitriptyline in Neuropathic Pain: Two Cases and Literature Review

Drug therapy for chronic idiopathic axonal polyneuropathy

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