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Titolo:
Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain
Autore:
Morello, CM; Leckband, SG; Stoner, CP; Moorhouse, DF; Sahagian, GA;
Indirizzi:
Vet Affairs San Diego Healthcare Syst, Pharm Serv 119, San Diego, CA 92161USA Vet Affairs San Diego Healthcare Syst San Diego CA USA 92161 CA 92161USA Univ Calif San Diego, Med Ctr, Dept Neurosci, San Diego, CA 92103 USA UnivCalif San Diego San Diego CA USA 92103 osci, San Diego, CA 92103 USA
Titolo Testata:
ARCHIVES OF INTERNAL MEDICINE
fascicolo: 16, volume: 159, anno: 1999,
pagine: 1931 - 1937
SICI:
0003-9926(19990913)159:16<1931:RDSCTE>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
REFLEX SYMPATHETIC DYSTROPHY; TOOTH-PULP SENSATIONS; SYMPTOMATIC TREATMENT; MANAGEMENT; DRUGS; MEXILETINE; ANALGESIA; INTENSITY; NEURALGIA; RELIEVES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Morello, CM Vet Affairs San Diego Healthcare Syst, Pharm Serv 119, 3350 LaJolla Village Dr, San Diego, CA 92161 USA Vet Affairs San Diego HealthcareSyst 3350 La Jolla Village Dr San Diego CA USA 92161
Citazione:
C.M. Morello et al., "Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain", ARCH IN MED, 159(16), 1999, pp. 1931-1937

Abstract

Background: Reports of gabapentin use in diabetic peripheral neuropathy pain stimulate a need for controlled trials to determine its comparative efficacy to the therapeutic standard of amitriptyline hydrochloride. Objective: To determine the efficacy of gabapentin compared with amitriptyline in treating diabetic peripheral neuropathy pain. Design: Prospective, randomized, double-blind, double-dummy, crossover study. Setting: Veterans Affairs San Diego Healthcare System, Ambulatory Care Clinic. Patients: Twenty-eight veterans were referred by their primary care providers. Two patients withdrew before randomization because of no neuropathic pain after washout; a third withdrew for unexpected surgery that required analgesics. Three patients withdrew because of adverse effects and 1 for protocol violation. Interventions: Patients with stable glycemic control and neuropathic gain randomized to 6 weeks of therapy with gabapentin, 900 to 1800 mg/d, or amitriptyline hydrochloride; 25 to 75 mg/d, with a 1-week washout before crossover. Main Outcome Measures: Pain relief measured by pain scale with verbal descriptors and global pain score assessment at treatment end. Results: Participants and investigators were blinded throughout. Mean dosages were of gabapentin, 1565 mg/d, and of amitriptyline hydrochloride, 59 mg/d. Sixty-five percent of patients reached maximum dose with gabapentin and 54% with amitriptyline. Mean score diary analysis showed pain relief withgabapentin and amitriptyline was not significantly different (P =.26). Global data were obtained from 21 of 25; enrolled patients who completed the study. Moderate or greater pain relief was experienced in 11 (52%) of 21 patients with gabapentin and 14 (67%) of 21 patients with amitriptyline. Therewere no significant period or carry-over effects (P=.35). Conclusions: Although both drugs provide pain relief, mean pain score and global pain score data indicate no significant difference between gabapentin and amitriptyline. Gabapentin may be an alternative for treating diabeticperipheral neuropathy pain, yet does not appear to offer considerable advantage over amitriptyline and is more expensive. Larger trials are necessaryto define gabapentin's place in treating diabetic peripheral neuropathy pain.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/07/20 alle ore 07:59:49