Topiramate in Chronic Lumbar Radicular Pain

Khoromi, Suzan; Patsalides, Athos; Parada, Suzan; Salehi, Vesta; Meegan, Jennifer M.; Max, Mitchell B.

doi:10.1016/j.jpain.2005.08.002

Cited by 133 publications

(73 citation statements)

References 40 publications

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“…30 Three trials confirmed participant lumbar spine pathology radiographically (Appendix 4, available at www.cmaj.ca/lookup/suppl/ doi:10.1503/cmaj.171333/-/DC1). 28,29,34 The mean treatment duration was 6.7 weeks (range 10 d to 12 wk). The anticonvulsants investigated were gabapentinoids (pregabalin 27,29,30 or gabapentin 26,31,32,34 ) and topiramate.…”

Section: Resultsmentioning

confidence: 99%

Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis

Enke

New

et al. 2018

CMAJ

142

103

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Section: Resultsmentioning

confidence: 99%

Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis

Enke

New

et al. 2018

CMAJ

142

103

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“…In 3 RCTs, there was no evidence of efficacy of nortriptyline, 84 amitriptyline, 85 or gabapentin. 86 Finally, recent trials of nortriptyline and morphine and their combination 70 and pregabalin 87 and an equivocal trial of topiramate 88 suggest that lumbosacral radiculopathy might be a third peripheral NP condition that is relatively refractory to existing first-and second-line medications. Interestingly, patients with failed back surgery syndrome, many of whom have lumbosacral radiculopathy, appear to respond to spinal cord stimulation, 89 which suggests that this NP condition is not generally refractory to all treatment modalities.…”

Section: 79mentioning

confidence: 99%

Recommendations for the Pharmacological Management of Neuropathic Pain: An Overview and Literature Update

Dworkin

O’Connor

Audette

et al. 2010

Mayo Clinic Proceedings

1,148

901

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The Neuropathic Pain Special Interest Group of the International Association for the Study of Pain recently sponsored the development of evidence-based guidelines for the pharmacological treatment of neuropathic pain. Tricyclic antidepressants, dual reuptake inhibitors of serotonin and norepinephrine, calcium channel a 2 -d ligands (ie, gabapentin and pregabalin), and topical lidocaine were recommended as first-line treatment options on the basis of the results of randomized clinical trials. Opioid analgesics and tramadol were recommended as second-line treatments that can be considered for first-line use in certain clinical circumstances. Results of several recent clinical trials have become available since the development of these guidelines. These studies have examined botulinum toxin, high-concentration capsaicin patch, lacosamide, selective serotonin reuptake inhibitors, and combination therapies in various neuropathic pain conditions. The increasing number of negative clinical trials of pharmacological treatments for neuropathic pain and ambiguities in the interpretation of these negative trials must also be considered in developing treatment guidelines. The objectives of the current article are to review the Neuropathic Pain Special Interest Group guidelines for the pharmacological management of neuropathic pain and to provide a brief overview of these recent studies.Mayo Clin Proc. 2010;85(3)(suppl):S3-S14 DPN = diabetic peripheral neuropathy; HIV = human immunodeficiency virus; HRQoL = health-related quality of life; NeuPSIG = Neuropathic Pain Special Interest Group; NP = neuropathic pain; PHN = postherpetic neuralgia; RCT = randomized clinical trial; SSNRI = selective serotonin norepinephrine reuptake inhibitor; SSRI = selective serotonin reuptake inhibitor; TCA = tricyclic antidepressant

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“…However, the high study dropout rate and high incidence of side effects made the authors question the usefulness of this agent in this setting. 109 In a more recently published randomized, double-blind, placebo-controlled study of 96 patients with chronic low back pain, 110 topiramate appeared to be helpful. In this study, important changes were noted not only in pain sensitivity but in anger status and processing as well.…”

Section: Topiramatementioning

confidence: 99%

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

2007

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Summary: Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.

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Topiramate in Chronic Lumbar Radicular Pain

Cited by 133 publications

References 40 publications

Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis

Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis

Recommendations for the Pharmacological Management of Neuropathic Pain: An Overview and Literature Update

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

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