Emily Carol McKinley1, Elizabeth J Richardson2, Gerald McGwin3, Jie Zhang3. 1. a Department of Neurology, University of Alabama at Birmingham , Birmingham , Alabama , USA. 2. b Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham , Birmingham, Alabama , USA. 3. c Department of Epidemiology, University of Alabama at Birmingham School of Public Health , Birmingham, Alabama , USA.
Abstract
OBJECTIVE: To investigate if a combination of anticonvulsant and antidepressant, two primary therapies for neuropathic pain, is associated with improved pain control compared to individual therapy. DESIGN: Prospective cohort study Setting: The University of Alabama at Birmingham Rehabilitation Center In-patient Program between 2012 and 2015. PARTICIPANTS: Incident SCI cases, 19-65 years of age. OUTCOMES: Bryce-Ragnarsson pain classification scheme and the Numerical Rating Scale Results: Twenty-nine eligible patients completed 6-month follow-up; their average age was 36.4 years, 89% were male, and 65% were white. Baseline characteristics were not different by therapy initiated (combination versus single). At 6 months follow-up, therapy initiated at baseline was not associated with level of pain in the past week (p=0.3145) or past 24 hours (p=0.4107). However, patients who remained on the same therapy reported lower levels of pain 30 minutes after waking (p=0.0235). CONCLUSIONS: The initiation of a combination of anticonvulsant and antidepressant shortly after SCI was not associated with improved pain control at 6 months compared to individual therapy. Adherent patients reported lower levels of pain; further analysis is warranted to elucidate this association.
OBJECTIVE: To investigate if a combination of anticonvulsant and antidepressant, two primary therapies for neuropathic pain, is associated with improved pain control compared to individual therapy. DESIGN: Prospective cohort study Setting: The University of Alabama at Birmingham Rehabilitation Center In-patient Program between 2012 and 2015. PARTICIPANTS: Incident SCI cases, 19-65 years of age. OUTCOMES: Bryce-Ragnarsson pain classification scheme and the Numerical Rating Scale Results: Twenty-nine eligible patients completed 6-month follow-up; their average age was 36.4 years, 89% were male, and 65% were white. Baseline characteristics were not different by therapy initiated (combination versus single). At 6 months follow-up, therapy initiated at baseline was not associated with level of pain in the past week (p=0.3145) or past 24 hours (p=0.4107). However, patients who remained on the same therapy reported lower levels of pain 30 minutes after waking (p=0.0235). CONCLUSIONS: The initiation of a combination of anticonvulsant and antidepressant shortly after SCI was not associated with improved pain control at 6 months compared to individual therapy. Adherent patients reported lower levels of pain; further analysis is warranted to elucidate this association.
Authors: Scot H Simpson; Dean T Eurich; Sumit R Majumdar; Rajdeep S Padwal; Ross T Tsuyuki; Janice Varney; Jeffrey A Johnson Journal: BMJ Date: 2006-06-21
Authors: R Mann; C Schaefer; A Sadosky; F Bergstrom; R Baik; B Parsons; S Nalamachu; B R Stacey; M Tuchman; A Anschel; E C Nieshoff Journal: Spinal Cord Date: 2013-04-16 Impact factor: 2.772