Pharmacologic Treatment of Neuropathic Pain Following Spinal Cord Injury

DeFrates, Sean; Cook, Aaron M.

doi:10.3928/01477447-20110124-19

Cited by 10 publications

(6 citation statements)

References 20 publications

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“…Neuropathic pain is one of the most debilitating complications of spinal cord injury and since the underlying mechanisms are only partly understood, it is difficult to treat (Wrigley et al, 2009 ; Defrates and Cook, 2011 ). Therefore, multidisciplinary neurorehabilitation interventions acting simultaneously on different symptoms are needed (Grade of recommendation: GPP) (Heutink et al, 2014 ).…”

Section: Evidences and Discussionmentioning

confidence: 99%

Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

et al. 2016

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Background: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams.Objectives: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases.Methods: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions.Results: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive—Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post—Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache.Conclusions: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the paper.

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Section: Evidences and Discussionmentioning

confidence: 99%

Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

et al. 2016

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“…Davari, et al due to SCI [18,19]. Both drugs have been shown to be effective in the treatment of neuropathic pain due to postherpetic neuralgia [20][21][22][23][24][25][26] and diabetic peripheral neuropathy [24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis

Davari

Amani

et al. 2020

Korean J Pain

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“…Although structurally similar to GABA, gabapentin does not affect the uptake, synthesis, or metabolism of GABA ( 68 ) nor do either gabapentin or pregabalin bind to GABAA or GABAB receptors ( 69 – 71 ). Hence, gabapentin is commonly recommended as immediate therapy for the management of post-SCI NP ( 72 , 73 ). Besides, pregabalin as a new generation of gabapentinoid is the only drug approved by the US Food and Drug Administration (FDA) for the treatment of post-SCI NP.…”

Section: Discussionmentioning

confidence: 99%

Comparative Efficacy and Safety of 11 Drugs as Therapies for Adults With Neuropathic Pain After Spinal Cord Injury: A Bayesian Network Analysis Based on 20 Randomized Controlled Trials

Ling

Chen

et al. 2022

Front. Neurol.

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ObjectiveTo provide an updated analysis of the efficacy and safety of drugs for the management of neuropathic pain (NP) after spinal cord injury (SCI) based on Bayesian network analysis.MethodsA Bayesian network meta-analysis of literature searches within PubMed, Cochrane Library, Embase, and Web of Science databases from their inception to February 21 2021 was conducted without language restrictions. Paired and network meta-analyses of random effects were used to estimate the total standardized mean deviations (SMDs) and odds ratios (ORs).ResultsA total of 1,133 citations were identified and 20 RCTs (including 1,198 patients) involving 11 drugs and placebos for post-SCI NP selected. The 5 outcomes from all 11 drugs and placebos had no inconsistencies after Bayesian network analysis. BTX-A gave the most effective pain relief for the 4 weeks, following a primary outcome. No significant differences were found among drugs with regard to adverse events of the primary outcome. Gabapentin, BTX-A, and pregabalin were found to be the most helpful in relieving secondary outcomes of mental or sleep-related symptoms with differences in SMDs, ranging from −0.63 to −0.86. Tramadol triggered more serious adverse events than any of the other drugs with differences in ORs ranging from 0.09 to 0.11.ConclusionBTX-A, gabapentin, pregabalin, amitriptyline, ketamine, lamotrigine, and duloxetine were all effective for NP management following SCI. Lamotrigine and gabapentin caused fewer side effects and had better efficacy in relieving mental or sleep-related symptoms caused by SCI-related NP. Tramadol, levetiracetam, carbamazepine, and cannabinoids could not be recommended due to inferior safety or efficacy.Systematic Review Registration[https://inplasy.com/inplasy-2020-7-0061/], identifier [INPLASY202070061].

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Pharmacologic Treatment of Neuropathic Pain Following Spinal Cord Injury

Cited by 10 publications

References 20 publications

Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis

Comparative Efficacy and Safety of 11 Drugs as Therapies for Adults With Neuropathic Pain After Spinal Cord Injury: A Bayesian Network Analysis Based on 20 Randomized Controlled Trials

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