Effect of melatonin on the daytime sleepiness side-effect of gabapentin in adults patients with neuropathic pain

Altıparmak, Başak; Çil, Hemra; Çelebi, Nalan

doi:10.1016/j.bjane.2018.08.002

Cited by 8 publications

(20 citation statements)

References 29 publications

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“…1 , Table 1 ). 5 , 24 , 26 , 27 , 34 , 35 , 54 , 59 , 68 , 74 Attempts were made to contact 4 authors to request additional data not reported in the original article 24 , 26 , 35 , 68 ; 2 authors replied but were not able to provide data, 26 , 68 2 failed to reply. 24 , 35 …”

Section: Resultsmentioning

confidence: 99%

“…A summary of risk of bias assessment according to the domain-based Cochrane tool is provided in Figure 2 and Appendix 3, available at http://links.lww.com/PR9/A185 . Only 3 of 10 studies were deemed to be at low risk of bias 5 , 24 , 74 ; 2 studies were labeled high risk of bias (due to attrition bias). 34 , 35 Given that only 6 studies were included in the meta-analysis, we chose not to assess publication bias with funnel plots.…”

Section: Resultsmentioning

confidence: 99%

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Analgesic efficacy of sleep-promoting pharmacotherapy in patients with chronic pain: a systematic review and meta-analysis

Andersson

Kander

Werner

et al. 2023

PR9

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Dysregulation of sleep heightens pain sensitivity and may contribute to pain chronification. Interventions which consolidate and lengthen sleep have the potential to improve pain control. The main objective of this systematic review was to examine the effects of sleep-promoting pharmacotherapy on pain intensity in patients with chronic pain. Multiple electronic databases were searched from inception to January 2022 to identify relevant randomized controlled trials (RCTs). Two independent reviewers screened titles, abstracts, and full-text articles; extracted data; and assessed risk of bias for each included study. The GRADE approach was used to determine the strength of evidence. The search identified 624 articles. After full-text screening, 10 RCTs (n 5 574 randomized participants) involving 3 pharmacologic interventions (melatonin, zopiclone, and eszopiclone) and 7 different chronic pain populations were included. Minimum clinically significant pain reduction $30% was reported in 4 studies. There is low-quality evidence (downgraded due to inconsistency and imprecision) that 2 to 8 weeks treatment with a sleep-promoting medication alone or in combination with an analgesic (6 trials, n 5 397) decreases pain intensity compared with placebo or the same analgesic treatment alone (SMD 20.58 [95% confidence interval 21.00, 20.17], P 5 0.006). Analyses of associations between changes in sleep and pain outcomes were only provided in 2 articles, with inconsistent findings. Notably, pain-relieving effects were most consistent in melatonin trials. Only 3 studies implemented polysomnography to obtain objective sleep measures. Low-quality evidence indicates that pharmacologic sleep promotion may decrease pain intensity in chronic pain populations. More research is needed to fully understand the influence of sleep-targeting interventions on pain control.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Analgesic efficacy of sleep-promoting pharmacotherapy in patients with chronic pain: a systematic review and meta-analysis

Andersson

Kander

Werner

et al. 2023

PR9

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“…The duration of pain was not reported in the remaining five trials [11,22,31,34,39]. In the methodological quality score assessed by the Cochrane Risk of Bias Tool, the average number of low risk of bias was 5.8, and 19 trials demonstrated low risk of bias in 6 items or more and were considered to be high quality [14,16,[18][19][20][21][22]24,28,29,[31][32][33][34][35][36][37][38][39], while the remaining 11 trials demonstrated a low risk of bias in 5 items or less [11][12][13]15,17,23,[25][26][27]30,40] (Table 2).…”

Section: General Characteristics Of Trialsmentioning

confidence: 99%

“…Out of 30 trials, 12 trials investigated acute postoperative pain after the surgery under general anesthesia [12][13][14][15][18][19][20]24,26,30,36,40], four trials did acute postoperative pain after the surgery under local and epidural anesthesia [15,25,28,29], four trials investigated acute procedural pain [23,27,32,33], and five trials investigated chronic pain [17,21,35,37,38]. The duration of pain was not reported in the remaining five trials [11,22,31,34,39]. In the methodological quality score assessed by the Cochrane Risk of Bias Tool, the average number of low risk of bias was 5.8, and 19 trials demonstrated low risk of bias in 6 items or more and were considered to be high quality [14,16,[18][19][20][21][22]24,28,29,[31][32][33][34][35]…”

Section: General Characteristics Of Trialsmentioning

confidence: 99%

Analgesic Efficacy of Melatonin: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials

Oh¹,

Myung

Jho³

2020

JCM

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Previous systematic reviews and meta-analyses of randomized controlled trials have reported controversial findings regarding the effects of melatonin on pain reduction. The aim of this study was to evaluate the efficacy of melatonin on pain among adults using a meta-analysis of randomized, double-blind, placebo-controlled trials (RDBPCTs). PubMed, EMBASE, the Cochrane Library, and the bibliographies of relevant articles were searched up to February 2020. Two of the authors independently evaluated eligibility of the studies based on the pre-determined criteria and extracted data. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) for the pain score change were calculated using a random-effects meta-analysis. Out of 463 that met the initial criteria, a total of 30 trials, which involved 1967 participants with 983 in an intervention group and 984 in a control group, were included in the final analysis. In a random-effects meta-analysis, the use of melatonin reduced chronic pain in all the trials (5 studies, SMD −0.65, 95% CI −0.96 to −0.34, I2 = 57.2%) and high-quality trials (4 studies, SMD −0.62, 95% CI −1.01 to −0.23, I2 = 49.3%). Moreover, the use of melatonin significantly reduced acute postoperative pain (11 studies, SMD −0.82, 95% CI −1.40 to −0.25, I2 = 93.0%). However, the subgroup meta-analysis of high-quality RDBPCTs showed no significant association between them (6 studies, SMD −0.21, 95 % CI −0.66 to 0.24, I2 = 82.4%). The current study suggests that melatonin might be used in treatment of chronic pain, while there is no sufficient evidence for acute postoperative or procedural pain. Further trials are warranted to confirm its analgesic effect.

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“…Such neuropathic pain that occurs after chemotherapy lowers the quality of life (QoL) of patients and is one of the primary reasons why patients abandon chemotherapy 10–13 . To treat these side effects, antidepressant or anticonvulsant drugs, such as duloxetine or gabapentin, are referred for patients as a first‐line treatment; however, these drugs have been reported to be accompanied by dizziness, nausea, somnolence and vomiting 14–17 …”

Section: Introductionmentioning

confidence: 99%

Analgesic effects of medicinal plants and phytochemicals on chemotherapy‐induced neuropathic pain through glial modulation

Lee

Kim

Park

et al. 2021

Pharmacology Res & Perspec

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Chemotherapy‐induced peripheral neuropathy (CIPN) frequently occurs in cancer patients. This side effect lowers the quality of life of patients and may cause the patients to abandon chemotherapy. Several medications (e.g., duloxetine and gabapentin) are recommended as remedies to treat CIPN; however, usage of these drugs is limited because of low efficacy or side effects such as dizziness, nausea, somnolence, and vomiting. From ancient East Asia, the decoction of medicinal herbal formulas or single herbs have been used to treat pain and could serve as alternative therapeutic option. Recently, the analgesic potency of medicinal plants and their phytochemicals on CIPN has been reported, and a majority of their effects have been shown to be mediated by glial modulation. In this review, we summarize the analgesic efficacy of medicinal plants and their phytochemicals, and discuss their possible mechanisms focusing on glial modulation in animal studies.

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Effect of melatonin on the daytime sleepiness side-effect of gabapentin in adults patients with neuropathic pain

Cited by 8 publications

References 29 publications

Analgesic efficacy of sleep-promoting pharmacotherapy in patients with chronic pain: a systematic review and meta-analysis

Analgesic efficacy of sleep-promoting pharmacotherapy in patients with chronic pain: a systematic review and meta-analysis

Analgesic Efficacy of Melatonin: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials

Analgesic effects of medicinal plants and phytochemicals on chemotherapy‐induced neuropathic pain through glial modulation

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