Background:Neuropathic pain in cancer patients remain a treatment challenge. Many of the anticancer drugs have to be abandoned because patients develop neuropathic pain. Several antiepileptic drugs like carbamazepine, phenytoin, lamotrigine, felbamate are effective in neuropathic pain and trigeminal neuralgia. However, their efficacy varies.Aim:The aim of this study is to compare the efficacy of antiepileptic drugs in neuropathic pain induced by anticancer drugs.Materials and Methods:Neuropathic pain was induced in rats by injecting 4 doses of paclitaxel. The rats were divided into four groups of six animals each. Group I was treated with oral carbamazepine (cbz) 100 mg/kg, group II received oral gabapentin (gbp) 60 mg/kg, and group III was treated with oral lamotrigine (lam) 40 mg/kg and group IV was the control group. Behavioural testing for thermal hyperalgesia and mechanical hyperalgesia was assessed from 26th day of paclitaxel administration to next five days by hot plate method and Randall Siletto test, respectively, in all the four groups. One way analysis of variance followed by Scheffe's post hoc test was used for statistical analysis.Results:In thermal hyperalgesia lam treated group was found to be significantly (P < 0.001) superior to cbz and gbp treated group. In mechanical hyperalgesia, lam group showed significant response (P < 0.05) as compared to gbp group. However, the gbp treated group showed a significant (P < 0.01) improvement after three days of treatment.Conclusions:In paclitaxel induced neuropathic pain, lamotrigine appears to be a promising drug. The difference in responses shown by different antiepileptics’ depends on the etiology of the underlying mechanisms in neuropathic pain.
Context: Anti-epileptics are used in the treatment of neuropathic pain. Newer anti-epileptics with improved safety profile are being used in neuropathic pain. The animal models of neuropathic pain have helped to find newer drugs for this condition. As the efficacy of these drugs is modest, there is always a need to compare the efficacy of newer anti-epileptics with conventional drugs in this condition. Aims: The aim of this study was to compare the efficacy of anti-epileptics in neuropathic pain induced by chronic constriction injury. Settings and Design: It was a randomised, prospective study. Materials and Methods: The rats were divided into four groups. The first three groups were administered each of carbamazepine, gabapentin and lamotrigine respectively and the fourth group acted as control. Assessment was started on day five of surgery by hot plate method and Randall Selitto test. Statistical Analysis Used: Statistical analysis was done by one way analysis of variance followed by posthoc test. Results: In mechanical allodynia rats treated with lamotrigine and gabapentin (P = 0.001) showed a significant increase in mechanical threshold whereas in thermal hyperalgesia, it was the carbamazepine (P = 0.027) which was superior to other two drugs. Conclusions: Lamotrigine and gabapentin are efficacious in mechanical allodynia whereas carbamazepine is superior in thermal hyperalgesia. This shows that effect of drugs vary in different behavioral tests. So, the choice of treatment in different types of neuropathic pain can vary.
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