Oxcarbazepine monotherapy in postherpetic neuralgia unresponsive to carbamazepine and gabapentin

Criscuolo, Salvatore; Auletta, Caterina; Lippi, S.; Brogi, F.; Brogi, Alessandra

doi:10.1111/j.1600-0404.2005.00300.x

Cited by 26 publications

(10 citation statements)

References 10 publications

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“…However, rapid onset of action was noticed with fixed dose pregabalin which may reflect the higher dose during the first week of treatment with this regime (103). Recent studies have evaluated the effectiveness and safety of oxcarbazepine and divalproex sodium (valproic acid and sodium valproate) for the treatment of postherpetic neuralgia (104,105). In an open-label trial, oxcarbazepine monotherapy administered for 8 weeks resulted in a statistically significant effect on pain reduction, allodynia and improvement in quality of life among patients with post-herpetic neuralgia (104).…”

Section: Anticonvulsantsmentioning

confidence: 99%

Varicella zoster virus: review of its management

Mustafa

Arduino

Porter

2009

J Oral Pathology Medicine

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Varicella zoster virus (VZV) is one of eight herpes viruses known to infect humans. Primary infection causes varicella (chickenpox), after which virus becomes latent. Years later, VZV reactivates and causes a wide range of neurological diseases. The aim of the present report was to critically examine the published literature to evaluate advantages and limitations of therapy of VZV infection in both immunocompetent and immunocompromised patients. Aciclovir (ACV) has been the drug of choice for many years for the treatment of VZV infections. Recently, other antiviral agents have been developed to overcome the low oral bioavailability of ACV, as well as to provide a more flattering dosage regime. Chickenpox is a benign self-limiting disease in the majority of cases and usually no specific treatment is required. Treatment of shingles is indicated to reduce the acute symptoms of pain and malaise, to limit the spread and duration of the skin lesions and to prevent the development of post-herpetic neuralgia. Different classes of drugs have been used for the treatment of post-herpetic neuralgia. The first choice of any of these medications should be guided by the patient's medical health, the likely adverse effects of the drug and the patient's preference.

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Section: Anticonvulsantsmentioning

confidence: 99%

Varicella zoster virus: review of its management

Mustafa

Arduino

Porter

2009

J Oral Pathology Medicine

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“…The optimal dose to be administered has not yet been thoroughly assessed. Other recently studied antiepileptic drugs are sodium divalproate and oxcarbazepine, which demonstrated a significant efficacy in reducing pain and improving patient quality of life 96,97…”

Section: Resultsmentioning

confidence: 99%

“…Capsaicin formulations are promising (level A), but the long-term effects of repeated applications are not well described, particularly on sensation 68,102. Other antiepileptic drugs (valproate) may be associated in patients with inadequate pain relief or intolerance to previously indicated medications 96,97…”

Section: Discussionmentioning

confidence: 99%

Post-herpetic neuralgia

Parruti¹,

Tontodonati²,

Ursini³

et al. 2012

IJGM

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BackgroundIn spite of the large body of evidence available in the literature, definition and treatment of Post-Herpetic Neuralgia (PHN) are still lacking a consistent and universally recognized standardization. Furthermore, many issues concerning diagnosis, prediction and prevention of PHN need to be clarified in view of recent contributions.ObjectivesTo assess whether PHN may be better defined, predicted, treated and prevented in light of recent data, and whether available alternative or adjunctive therapies may improve pain relief in treatment recalcitrant PHN.MethodsSystematic reviews, meta-analyses, randomized controlled trials, cohort studies and protocols were searched; the search sources included PubMed, Cochrane Library, NICE, and DARE. More than 130 papers were selected and evaluated.ResultsDiagnosis of PHN is essentially clinical, but it can be improved by resorting to the many tools available, including some practical and accessible questionnaires. Prediction of PHN can be now much more accurate, taking into consideration a few well validated clinical and anamnestic variables. Treatment of PHN is presently based on a well characterized array of drugs and drug associations, including, among others, tricyclic antidepressants, gabapentinoids, opioids and many topical formulations. It is still unsatisfactory, however, in a substantial proportion of patients, especially those with many comorbidities and intense pain at herpes zoster (HZ) presentation, so that this frequent complication of HZ still strongly impacts on the quality of life of affected patients.ConclusionFurther efforts are needed to improve the management of PHN. Potentially relevant interventions may include early antiviral therapy of acute HZ, prevention of HZ by adult vaccination, as well as new therapeutic approaches for patients experiencing PHN.

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“…A small open-label trial suggested it was effective for postherpetic neuralgia in patients who got no relief from carbamazepine and gabapentin. 52 In a larger placebo-controlled trial, 53 patients with painful diabetic neuropathy for at least 6 months had significantly better pain scores than at baseline after treatment with oxcarbazepine, suggesting it has a role as monotherapy in chronic painful diabetic neuropathy.…”

Section: Lidocaine Patches Should Be Worn For 12 Hours On 12 Hours Offmentioning

confidence: 99%

Clinical approach to patients with neuropathic pain.

Stillman

2006

Cleveland Clinic Journal of Medicine

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At long last, advances have been made in the field of neuropathic pain treatment, in large part due to a better understanding of the mechanisms underlying this type of pain. New antidepressants and anticonvulsants with novel mechanisms of action have spearheaded the way, and studies have finally shown that opioids are effective for treating chronic and breakthrough pain. ■ KEY POINTS Often, no single drug relieves the pain completely: combination therapy with agents that work at different sites and by different mechanisms may be necessary. Tricyclic antidepressants are a first-line therapy, especially for pain that disturbs sleep and contributes to depression. Classic teaching holds that neuropathic pain is opioidresistant, but recently, several carefully conducted trials have found opioid analgesics to be effective for neuropathic pain. Serotonin-norepinephrine reuptake inhibitors (SNRIs) are more effective than selective serotonin reuptake inhibitors (SSRIs) for neuropathic pain. Lidocaine patches are useful for discrete areas of pain, especially for hypersensitivity. Pregabalin, a new, rapidly acting antiepileptic drug, has been approved for treatment of painful diabetic neuropathy and postherpetic neuralgia. Nonopioid analgesics such as acetaminophen can be used as adjuncts. EUROPATHIC PAIN SYNDROMES are challenging to treat. New drugs aim at the mechanisms of the pain, but results are still less than desirable. Newer antidepressants and anticonvulsive drugs are becoming first-line treatments in many patients. And we now know that, contrary to conventional wisdom, opioids do have a role in treating neuropathic pain. Still, there is no definitive algorithm for treatment. Rather, physicians often will have to combine agents in order to provide patients with relief from their pain. This article reviews how to classify a patient's pain on the basis of the clinical picture, discusses the physiology of pain, and provides several approaches to managing common neuropathic pain syndromes, with two cases to illustrate the art and the science of treatment.

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Oxcarbazepine monotherapy in postherpetic neuralgia unresponsive to carbamazepine and gabapentin

Abstract: Oxcarbazepine appears to be a promising alternative monotherapeutic approach for patients affected by PHN.

Cited by 26 publications

References 10 publications

Varicella zoster virus: review of its management

Varicella zoster virus: review of its management

Post-herpetic neuralgia

Clinical approach to patients with neuropathic pain.

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