Mexiletine for Treatment of Chronic Painful Diabetic Neuropathy

Dejgård, A; Petersen, Palle; Kastrup, Jens

doi:10.1016/s0140-6736(88)90999-3

Cited by 345 publications

(99 citation statements)

References 15 publications

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“…Mexiletine, a class IB antiarrythmic agent, is a structural analogue of lidocaine; it has been used with mixed success to treat various neuropathies (193). There are four randomized, controlled trials examining the analgesic potential of mexiletine in diabetic neuropathy, three with positive results (194)(195)(196) and one demonstrating no difference between mexiletine and placebo (197). Evidence indicates that patients with stabbing or burning pain, heat sensations or tingly, crawling sensations benefit the most (195).…”

Section: Other Agents Used For Chronic Painmentioning

confidence: 99%

The Pharmacotherapy of Chronic Pain: A Review

Lynch

Watson

2006

Pain Research and Management

101

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The past two decades have contributed a large body of preclinical work that has assisted in our understanding of the underlying pathophysiological mechanisms that cause chronic pain. In this context, it has been recognized that effective treatment of pain is a priority and that treatment often involves the use of one or a combination of agents with analgesic action. The current review presents an evidence-based approach to the pharmacotherapy of chronic pain. Medline searches were done for all agents used as conventional treatment in chronic pain. Published papers up to June 2005 were included. The search strategy included randomized, controlled trials, and where available, systematic reviews and meta-analyses. Further references were found in reference sections of papers located using the above search strategy. Agents for which there were no controlled trials supporting efficacy in treatment of chronic pain were not included in the present review, except in cases where preclinical science was compelling, or where initial human work has been positive and where it was thought the reader would be interested in the scientific evidence to date.Key Words: Anticonvulsants; Antidepressants; Cannabinoids; Chronic pain; Opioids; Pharmacotherapy; Topical analgesics La pharmacothérapie de la douleur chronique : Une analyse Les deux dernières décennies ont contribué à un vaste ensemble de travaux précliniques qui nous ont permis de mieux comprendre les mécanismes physiopathologiques sous-jacents responsables de la douleur chronique. Dans ce contexte, il est admis que le traitement efficace de la douleur est une priorité et qu'il exige souvent le recours à un agent ou à une association d'agents ayant une action analgésique. La présente analyse présente une démarche probante de la pharmacothérapie de la douleur chronique. Des recherches dans Medline ont été effectuées sur tous les agents utilisés pour le traitement classique de la douleur chronique. Les articles publiés jusqu'en juin 2005 ont été inclus. La stratégie de recherche incluait les essais aléatoires et contrôlés et, si elles étaient disponibles, les analyses systématiques et les méta-analyses. D'autres références ont été obtenues dans la partie des références des articles trouvés à l'aide de la stratégie de recherche précédente. Les agents dont aucun essai contrôlé n'étayait l'efficacité pour le traitement de la douleur chronique étaient exclus de la présente analyse, sauf si les données scientifiques précliniques étaient convaincantes, si les travaux humains initiaux étaient positifs ou si on pensait que les données scientifiques colligées jusque-là étaient intéressantes pour le lecteur.

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Section: Other Agents Used For Chronic Painmentioning

confidence: 99%

The Pharmacotherapy of Chronic Pain: A Review

Lynch

Watson

2006

Pain Research and Management

101

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“…In a RCT on patients with neuropathic pain with prominent allodynia, at doses of up to 900 mg/d, mexiletine showed no significant effects on pain and allodynia of NP. [54,55,56] Combination therapy Neuropathic pain is a complex syndrome and most of the monotherapies often fail to provide sufficient analgesia even at the highest recommended dose [57] because a single drug is unable to effectively modify the complex cellular and molecular changes seen in chronic NP conditions. [58] Therefore, it is logical to target different pain mechanisms using combination therapy.…”

Section: Mexiletinementioning

confidence: 99%

Recent and Emerging Trends in Pharmacotherapy of Neuropathic Pain

Singh

Sehgal

Singh

2018

IJMDS

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“…139,143 Intraveneous lidocaine was eective in CRPS. 144 Care needs to be taken when administering these compounds.…”

Section: Pharmacological Therapymentioning

confidence: 99%

Complex regional pain syndrome – diagnostic, mechanisms, CNS involvement and therapy

et al. 2003

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Complex regional pain syndromes (CRPS, formerly re¯ex sympathetic dystrophy and causalgia) are neuropathic pain conditions of one extremity developing inadequately after a trauma. The initiating trauma aects primarily the extremity, but can also be a central lesion (e.g., spinal cord injury, stroke). CRPS is clinically characterized by sensory, autonomic and motor disturbances. Pathophysiologically there is evidence for functional changes within the central nervous system and for involvement of peripheral in¯ammatory processes. The sympathetic nervous system plays a key role in maintaining pain and autonomic dysfunction in the aected extremity. After a primary central lesion, secondary peripheral changes in the paretic extremity are suggested to be important in initiating a CRPS. Though there is no diagnostic gold standard, careful clinical evaluation and additional test procedures should lead to an adequate diagnosis. An early diagnosis and an interdisciplinary approach are important for optimal and successful treatment.

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Mexiletine for Treatment of Chronic Painful Diabetic Neuropathy

Cited by 345 publications

References 15 publications

The Pharmacotherapy of Chronic Pain: A Review

The Pharmacotherapy of Chronic Pain: A Review

Recent and Emerging Trends in Pharmacotherapy of Neuropathic Pain

Complex regional pain syndrome – diagnostic, mechanisms, CNS involvement and therapy

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