Pregabalin in chemotherapy induced neuropathic pain

Abstract

Chemotherapeutic agents belonging to vinca alkaloids, taxanes, and antitubulins produce peripheral neuropathy for which there is no validated treatment. Pregabalin, a gamma-aminobutyric acid analog, is known to inhibit theα2δ subunit of the voltage-gated calcium channel. Earlier studies and case reports have shown pregabalin to be effective in treating neuropathic pain. We present a case series of patients with chemotherapy-induced peripheral neuropathy who were successfully treated with pregabalin with reduction in the hyperalgesia, allodynia, and improvement in the quality of life.

Comparative analgesic efficacy of pregabalin administered according to either a prevention protocol or an intervention protocol in rats with cisplatin‐induced peripheral neuropathy

“…Additionally, combination therapy comprising pregabalin and tramadol had a positive impact on CIPN in patients administered taxane‐based chemotherapy regimens . Furthermore, a case series of patients with CIPN who were successfully treated with pregabalin reported reductions in hyperalgesia and allodynia and an improvement in quality of life …”

“…For patients who are experiencing CIPN, the antidepressant, duloxetine, is recommended although the magnitude of benefit is modest and much less than is desirable . In several case series, pregabalin reportedly alleviated CIPN with a relatively good safety profile . However, this is insufficient evidence to support a recommendation for the use of pregabalin to alleviate CIPN .…”

Safety and usefulness of Laghu shankha prakshalana in patients with essential hypertension: A self controlled clinical study

“…Yoga texts clearly mention that the aim of any yoga practice, whether physical, breathing, mental or emotional, is to reach a state of control ( chittavrtti nirodha ) over the responses to situations (healthy stress response)[ 7 ] by the process of slowing or silencing the mind. [ 8 ] Internal awareness of the changes in the mind helps in conscious slowing down and thus offers physiological rest. Sage Gaudapada in his treatise, mandukya karika ,[ 3 ] proposes a concept that one can go on deepening the level of rest by using a series of alternate stimulations (physical stretch or breath awareness or chanting) followed by relaxation technique.…”

“…Promising therapies amongst these include imagery and hypnosis, meditation, yoga , tai chi, prayer, music, exercise, diet and use of dietary supplements. [ 6 ] Yoga offers several practices that help in mastery over the modifications of the mind ( chitta vritti nirodha )[ 7 ] through the process of calmness of mind ( mana prashamana upaya )[ 8 ] to reach a state of balanced functioning of the mind-body complex ( samatvam yoga uchyate ). [ 9 ] Integrated approach of Yoga therapy (IAYT) involves selecting physiologically acceptable and useful practices that can be grouped under four domains ( raja yoga, karma yoga, bhakti yoga and jnana yoga ).…”

“…[ 12 13 ] Yoga and Ayurveda , the Indian systems of medicine, lay emphasis on clearing the bowel as an essential component of therapy based on its disease model. [ 14 15 ] This model of hypertension, a life style disease ( adhija vyadhi ),[ 8 ] proposes that these diseases begin in the mind as persitent long standing emotional responses to stressful demanding situations of life ( adhi = stress); these (uncontrolled rewinding thoughts) manifest as disturbed breathing and digestive functions (poor appetite and constipation) due to prana (chi or vital energy) imbalance. As time lapses, this habituated imbalance of prana percolates to the body level ( annamaya kosha ) causing biochemical imbalances that shows up as hypertension.…”