Update on Neuropathic Pain Treatment: Ion Channel Blockers and Gabapentinoids

Chen, Lucy; Mao, Jianren

doi:10.1007/s11916-013-0359-2

Cited by 11 publications

(12 citation statements)

References 90 publications

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“…Gabapentin, [1-(aminomethyl) cyclohexane acetic acid], is a synthetic analog of gamma-aminobutyric acid (GABA), which subsequently inhibits pain neurotransmission, particularly targeting neuropathic pain pathways (Taylor et al, 1998). Several hypotheses have been proposed to explain the mechanism of action of gabapentin, one of which is modulation of sodium or calcium channels, but there is limited evidence to support this hypothesis (Brown et al, 1996; Moore et al, 2002; Chen and Mao, 2013). It is known that gabapentin has effects on the central nervous system via increased serotonin concentrations, which is partly responsible for its pharmacodynamic effect.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Once-Daily Gabapentin Extended Release Formulation in Patients With Postamputation Pain

et al. 2019

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Objectives To compare gabapentin extended-release, a gastro-retentive formulation, in relieving postamputation pain among gabapentin-experienced and gabapentin-naïve patients. Design Open-labeled pilot study. Subjects Sixteen patients with postamputation pain (8 patients in the gabapentin-experienced and 8 patients in the gabapentin-naïve groups). Methods Patients were started on gabapentin extended-release and were followed up for 8 weeks. Patients reported their pain severity during rest and movement using a numeric rating scale (NRS), interference of pain with daily activities using the modified brief pain inventory (MBPI) questionnaire, and treatment satisfaction using the treatment satisfaction questionnaire for medication (TSQM). Results Patients from both gabapentin-experienced and gabapentin-naïve groups achieved a significant and sustainable pain relief over the course of therapy. The pain scores at rest decreased in both gabapentin-experienced and gabapentin-naïve groups from 5.88 ± 1.36 and 4.88 ± 2.95 to 1.88 ± 0.99 and 1.38 ± 1.51, respectively. An average percent of pain relief with gabapentin extended-release was noted to be significant ( p < 0.01) after 8 weeks of therapy among gabapentin-experienced (81.25 ± 16.42%) and gabapentin-naïve groups (85 ± 17.73%) when compared to baseline for gabapentin-experienced (31.25 ± 29%) and gabapentin-naïve groups (36.25 ± 34.2%), respectively. Gabapentin-experienced and gabapentin-naïve groups had no significant difference in global satisfaction from treatment (79.14 ± 10.47 and 83.3 ± 20.82), convenience of treatment (73.78 ± 19.04 and 90.44 ± 11.66), effectiveness of treatment (72.6 ± 10.1 and 79.73 ± 11.6). The only statistically significant difference among gabapentin-experienced and gabapentin-naïve groups was found in adverse event tolerability (65.78 ± 10.36 and 85.8 ± 10.14, p < 0.01). Conclusion Once-daily dosing of gabapentin-extended release showed significant improvement in pain severity and functional status, with no difference found between gabapentin-experienced versus gabapentin-naïve patients.

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Section: Discussionmentioning

confidence: 99%

The Effect of Once-Daily Gabapentin Extended Release Formulation in Patients With Postamputation Pain

et al. 2019

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“…Since vitamin D appears to be essential for musculoskeletal, neuronal, and immune health, all factors that may influence pain symptoms in ARU patients, our findings suggest that vitamin D status may truly influence pain. Given the relatively limited options now available in the management of pain in many ARU patients, 10 ‐ 18 this possibility merits further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…‐ 9 Traditional pharmacological therapies include opioids and nonsteroidal anti‐inflammatory drugs, 10 ‐ 12 which are of moderate benefit. Nontraditional pharmacological agents (such as calcium channel blockers, anticonvulsants, and muscle relaxants) have shown limited benefit 13 . ‐ 15 Furthermore, while nonpharmacological adjuncts such as acupuncture and massage therapy are thought to improve pain in ARU patients, 16 ‐ 18 evidence from adequately powered, randomized controlled trials (RCTs) is lacking.…”

Section: Introductionmentioning

confidence: 99%

Association Between Serum 25(OH)D Level and Nonspecific Musculoskeletal Pain in Acute Rehabilitation Unit Patients

Matossian-Motley

Drake

Samimi

et al. 2014

J Parenter Enteral Nutr

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Objective Nonspecific musculoskeletal pain can be difficult to manage in acute rehabilitation unit (ARU) patients. We investigated whether vitamin D status is a potential modifiable risk factor for nonspecific musculoskeletal pain in ARU patients. Materials and Methods This cross-sectional study focused on 414 adults from an inpatient ARU in Mission Viejo, California, between July 2011 and June 2012. On ARU admission, all patients had serum 25-hydroxyvitamin D (25(OH)D) levels measured and were assessed for nonspecific musculoskeletal pain. We performed multivariable logistic regression to test the association of serum 25(OH)D level with nonspecific musculoskeletal pain while adjusting for clinically relevant covariates. Results Among these 414 patients, mean (SD) 25(OH)D level was 29 (12) ng/mL, and 30% had nonspecific musculoskeletal pain. After adjustment for age, sex, race, body mass index, Functional Independence Measure score, Deyo-Charlson Comorbidity Index, fractures, steroid use, history of osteoporosis/osteomalacia, and patient type (orthopedic, cardiac, neurological, spinal cord injury, or traumatic brain injury), serum 25(OH)D level was inversely associated with nonspecific musculoskeletal pain (odds ratio [OR] per 10 ng/mL, 0.67; 95% confidence interval [CI], 0.48–0.82). When 25(OH)D level was dichotomized, patients with levels <20 ng/mL had higher odds of nonspecific musculoskeletal pain (OR, 2.33; 95% CI, 1.23–4.17) compared with patients with levels ≥20 ng/mL. Conclusions In adult patients, serum 25(OH)D level on admission to ARU was inversely associated with nonspecific musculoskeletal pain. These data support the need for randomized, controlled trials to test the role of vitamin D supplementation to improve nonspecific musculoskeletal pain in ARU patients.

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“…Gabapentin and pregabalin are used in the treatment of a number of chronic pain syndromes. 34 These compounds bind with high affinity to α2δ subunits of voltage-gated calcium channels in areas of the central nervous system involved in pain signalling. Both gabapentin and pregabalin have been demonstrated to alter pain and sensory thresholds to rectal distension in IBS patients.…”

Section: Interventions For Patients With Symptoms Refractory To Standard Pharmacological and Psychological Interventionsmentioning

confidence: 99%

Mechanisms and management of functional abdominal pain

Farmer

Aziz

2014

J R Soc Med

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SummaryFunctional abdominal pain syndrome is characterised by frequent or continuous abdominal pain associated with a degree of loss of daily activity. It has a reported population prevalence of between 0.5% and 1.7%, with a female preponderance. The pathophysiology of functional abdominal pain is incompletely understood although it has been postulated that peripheral sensitisation of visceral afferents, central sensitisation of the spinal dorsal horn and aberrancies within descending modulatory systems may have an important role. The management of patients with functional abdominal pain requires a tailored multidisciplinary approach in a supportive and empathetic environment in order to develop an effective therapeutic relationship. Patient education directed towards an explanation of the pathophysiology of functional abdominal pain is in our opinion a prerequisite step and provides the rationale for the introduction of interventions. Interventions can usefully be categorised into general measures, pharmacotherapy, psychological interventions and 'step-up' treatments. Pharmacotherapeutic/step-up options include tricyclic antidepressants, serotonin noradrenergic reuptake inhibitors and the gabapentinoids. Psychological treatments include cognitive behavioural therapy and hypnotherapy. However, the objective evidence base for these interventions is largely derived from other chronic pain syndrome, and further research is warranted in adult patients with functional abdominal pain.

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Update on Neuropathic Pain Treatment: Ion Channel Blockers and Gabapentinoids

Cited by 11 publications

References 90 publications

The Effect of Once-Daily Gabapentin Extended Release Formulation in Patients With Postamputation Pain

The Effect of Once-Daily Gabapentin Extended Release Formulation in Patients With Postamputation Pain

Association Between Serum 25(OH)D Level and Nonspecific Musculoskeletal Pain in Acute Rehabilitation Unit Patients

Mechanisms and management of functional abdominal pain

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