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Launette Marie Rieb, Wendy V Norman, Ruth Elwood Martin, Jonathan Berkowitz, Evan Wood, Michael John Milloy, Ryan McNeil
Introduction and objectives: Understanding the details of one individual's experience with pain, opioid use and withdrawal may generate insights into possible relationships between opioid-induced hyperalgesia and withdrawal-associated injury site pain (WISP). Methods: This case study was extracted from a mixed methods study that characterized WISP. In 2014, the individual was recruited from a primary care clinic that prescribes opioid agonist therapy. In an interview, she completed a 35-item survey and elaborated on her own experience...
May 2018: Pain Reports (Baltimore, Md.)
Thomas P Enggaard, Søren S Mikkelsen, Stine T Zwisler, Niels A Klitgaard, Søren H Sindrup
Background The antidepressant drugs imipramine and venlafaxine relieve clinical neuropathic pain and have been shown to increase pain thresholds in healthy volunteers during repetitive electrical sural nerve stimulation causing temporal pain summation, whereas pain during the cold pressor test is unaltered by these drugs. If this pattern of effect in experimental pain models reflects potential efficacy in clinical neuropathic pain, the pain summation model may potentially be used to identify new drugs for such pain conditions...
December 29, 2017: Scandinavian Journal of Pain
Anna Folkesson, Per Hartvig Honoré, Ole J Bjerrum
A high proportion of patients suffering from neuropathic pain do not receive satisfactory pain relief from their current treatment, due to incomplete efficacy and dose-limiting adverse effects. Hence, one strategy to improve treatment outcome is the use of a combination of analgesic drugs. The potential benefits of such approach include improved and prolonged duration of analgesic effect and fewer or milder adverse effects with lower doses of each drug. Gabapentin is recommended as a first-line drug in the treatment of neuropathic pain, and has recently been demonstrated to act on supraspinal structures to stimulate the descending noradrenergic pain inhibitory system...
December 29, 2017: Scandinavian Journal of Pain
A Basnet, S Butler, P Hartvig Honoré, M Butler, T E Gordh, K Kristensen, O J Bjerrum
Aims The clinical relevance of adding the acetylcholinesterase inhibitor donepezil to existing gabapentin treatment in patients with post-traumatic neuropathic pain was explored in this open-label study. The two drugs have previously shown synergism following co-administration in nerve-injured rats [1,2]. Methods The study comprised two consecutive periods of minimum six weeks: (1) titration of gabapentin until highest tolerable dose or maximum 24GG mg daily; and (2) addition of donepezil 5 mg once daily to the fixed gabapentin dose...
December 29, 2017: Scandinavian Journal of Pain
A Ritchie, J M Kramer
Burning mouth syndrome (BMS) is a debilitating condition that has a striking female predilection. Although the oral mucosa is normal in appearance, patients with BMS experience oral burning that most commonly localizes to the lips and tongue. BMS is a diagnosis of exclusion, and all underlying pathoses associated with allodynia must be ruled out prior to rendering the diagnosis. The etiopathogenesis of BMS remains poorly understood, and thus patient management is challenging. Data indicate that oral and systemic factors both contribute to the development and persistence of the condition...
June 1, 2018: Journal of Dental Research
Tomić Maja, Pecikoza Uroš, Micov Ana, Vučković Sonja, Stepanović-Petrović Radica
Inflammatory pain is the most common type of pain that is treated clinically. The use of currently available treatments (classic analgesics - NSAIDs, paracetamol and opioids) is limited by insufficient efficacy and/or side effects/tolerance development. Antiepileptic drugs (AEDs) are widely used in neuropathic pain treatment, but there is substantial preclinical evidence on their efficacy against inflammatory pain, too. In this review we focus on gabapentinoids (gabapentin and pregabalin) and dibenzazepine AEDs (carbamazepine, oxcarbazepine, and recently introduced eslicarbazepine acetate) and their potential for relieving inflammatory pain...
June 15, 2018: Pharmacology & Therapeutics
Edward Faught, Sandra Helmers, David Thurman, Hyunmi Kim, Linda Kalilani
OBJECTIVE: The objective of this study was to determine patient characteristics and antiepileptic drug (AED) treatment patterns in patients with newly diagnosed epilepsy in a United States (US) population followed for ≥180 days. METHODS: In this retrospective cohort study, Commercial, Supplemental Medicare, and Medicaid insurance claims from US-based Truven Health MarketScan® claims database were analyzed for incident epilepsy cases (index date: January 2010-June 2013; prior baseline of 2 years [1 year for ages 1 to <2 years; none for those <1 year])...
June 12, 2018: Epilepsy & Behavior: E&B
Sayed M Derayea, Tamer Z Attia, Mohamed Elnady
A new and simple spectrofluorimetric method was developed and validated for determination of gabapentin and pregabalin in their pure forms and pharmaceutical formulations with high sensitivity and selectivity. The proposed method was based on the formation of fluorescent products as a result of condensation reaction of investigated drugs with ninhydrin and phenyl acetaldehyde in Teorell and Stenhagen buffer medium. The fluorescent products had emission maxima at 470 nm after excitation at 375 nm. Parameters affecting the progress of the reaction and stability of the formed products were carefully investigated individually and optimized...
June 7, 2018: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
Andres M Kanner, Eric Ashman, David Gloss, Cynthia Harden, Blaise Bourgeois, Jocelyn F Bautista, Bassel Abou-Khalil, Evren Burakgazi-Dalkilic, Esmeralda Llanas Park, John Stern, Deborah Hirtz, Mark Nespeca, Barry Gidal, Edward Faught, Jacqueline French
OBJECTIVE: To update the 2004 American Academy of Neurology (AAN) guideline for treating new-onset focal or generalized epilepsy with second- and third-generation antiepileptic drugs (AEDs). METHODS: The 2004 AAN criteria were used to systematically review literature (January 2003-November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength. RESULTS: Several second-generation AEDs are effective for new-onset focal epilepsy...
June 13, 2018: Neurology
Konstantinos C Fragkos, John Barragry, Charisma Shahi Fernando, Marco Novelli, Joanna Begent, Natalia Zárate-Lopez
Eosinophilic colitis is a rare clinical condition that belongs to the group of eosinophilic gastrointestinal disorders. Its occurrence can be primary or secondary to infection, medications, or autoimmune/hematological conditions. We present a case of a young female adult with severe chronic fatigue syndrome, widespread chronic pain, including functional abdominal pain, who developed severe eosinophilic colitis following successive treatments with gabapentin and pregabalin. On both occasions, symptoms manifested as abdominal pain, diarrhea, and eosinophilia and improved upon discontinuation of the medications...
June 2018: Zeitschrift Für Gastroenterologie
Ying Zeng, Di Hu, Wei Yang, Emi Hayashinaka, Yasuhiro Wada, Yasuyoshi Watanabe, Qunli Zeng, Yilong Cui
Placebo analgesia is the beneficial effect that follows despite a pharmacologically inert treatment. Modern neuroimaging studies in humans have delineated the hierarchical brain regions involved in placebo analgesia. However, because of the lack of proper approaches to perform molecular and cellular manipulations, the detailed molecular processes behind it have not been clarified. To address this issue, we developed an animal model of placebo analgesia in rats and analyzed the placebo analgesia related brain activity using small-animal neuroimaging method...
June 5, 2018: NeuroImage
James J Thomas, Claire Levek, Hannah D Quick, John T Brinton, Sumeet Garg, Mindy N Cohen
OF BACKGROUND DATA: Posterior spinal fusion surgery for scoliosis requires extensive postoperative analgesic care. In 2014, we initiated the use of gabapentin as an adjunct for multimodal pain management in spine fusion patients. The effect of gabapentin on postoperative recovery in scoliosis patients was evaluated using the time to meet postoperative physical therapy goals. This measure was chosen because the actions required to achieve the goals are specific and reproducible. Secondary outcomes included morphine equivalents and maximum pain scores...
June 2018: Paediatric Anaesthesia
Korana Avdagic, Michelle Geier, Zlatan Coralic, Patrick Finley
Objective: To describe the effect of a multimodal intervention targeting chronic benzodiazepine and sedative-hypnotic prescriptions in a large behavioral health system. Methods: This retrospective study analyzed chronic sedative-hypnotic prescription rates in patients seeking mental health services in a large behavioral health system. The multimodal intervention consisted of provider education, coordination of care with all providers involved in patient care, and guideline development and implementation for safe prescribing of sedative-hypnotics...
May 31, 2018: Primary Care Companion to CNS Disorders
Szilvia Veszelka, András Tóth, Fruzsina R Walter, Andrea E Tóth, Ilona Gróf, Mária Mészáros, Alexandra Bocsik, Éva Hellinger, Monika Vastag, Gábor Rákhely, Mária A Deli
Cell culture-based blood-brain barrier (BBB) models are useful tools for screening of CNS drug candidates. Cell sources for BBB models include primary brain endothelial cells or immortalized brain endothelial cell lines. Despite their well-known differences, epithelial cell lines are also used as surrogate models for testing neuropharmaceuticals. The aim of the present study was to compare the expression of selected BBB related genes including tight junction proteins, solute carriers (SLC), ABC transporters, metabolic enzymes and to describe the paracellular properties of nine different culture models...
2018: Frontiers in Molecular Neuroscience
Julie H Ishida, Charles E McCulloch, Michael A Steinman, Barbara A Grimes, Kirsten L Johansen
Background Gabapentin and pregabalin are used to manage neuropathic pain, pruritus, and restless legs syndrome in patients on hemodialysis. These patients may be especially predisposed to complications related to these agents, which are renally cleared, but data regarding the risk thereof are lacking. Methods From the US Renal Data System, we identified 140,899 Medicare-covered adults receiving hemodialysis with Part D coverage in 2011. Using Cox regression models in which we adjusted for demographics, comorbidities, duration of exposure, number of medications, and use of potentially confounding concomitant medications, we investigated the association between gabapentin and pregabalin, modeled as separate time-varying exposures, and time to first emergency room visit or hospitalization for altered mental status, fall, and fracture...
June 5, 2018: Journal of the American Society of Nephrology: JASN
Guadalupe García, Vladimir A Martínez-Rojas, Norma Oviedo, Janet Murbartián
The aim of this study was to determine the participation of anoctamin-1 in 2 models of neuropathic pain in rats (L5/L6 spinal nerve ligation [SNL] and L5 spinal nerve transection [SNT]). SNL and SNT diminished withdrawal threshold in rats. Moreover, SNL up-regulated anoctamin-1 protein expression in injured L5 and uninjured L4 DRG whereas that it enhanced activating transcription factor 3 (ATF-3) and caspase-3 expression only in injured L5 DRG. In marked contrast, SNT enhanced ATF-3 and caspase-3, but not anoctamin-1, expression in injured L5 DRG but it did not modify anoctamin-1, ATF-3 nor caspase-3 expression in uninjured L4 DRG...
June 2, 2018: Brain Research
M B Houlind, C Treldal, M Aakjær, H Palm, B Malmquist, O Andersen, L L Christrup, K K Petersen
Aims Optimization of pain management is essential for fasttrack surgery and safety in acute hip fracture (AHF) patients. Kidney function determines the doses of several postoperative painkillers, but previous studies have shown the standard Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation overestimate glomerular filtration rate (GFR) in elderly and underweight patients. The optimized Cockcroft Gault (CGop) equation might be more accurate in this patient group. The study aims to (1) investigate the differences in estimated GFR (eGFR) based on CKD-EPI and CGop and (2) to simulate this impact on recommended dosing of standard painkillers in AHF patients...
December 29, 2017: Scandinavian Journal of Pain
W Z Pawlak, L Svensson, P F Jensen
Background Symptoms from disseminated cancer can develop very slowly. This could be very difficult to distinguish those symptoms from chronic disabilities and nuisances in patients with chronic non-malignant pain. Objective In this report, the case of a woman with both nonmalignant pain and cancer is presented. Case report A 54 years old woman was referred by a general practitioner to Multidisciplinary Pain Center. The diagnosis was chronic non-malignant neck pain on the basis of degenerative columnar disease...
December 29, 2017: Scandinavian Journal of Pain
M B Jensen, M M Andersen, B Boesen, M B Jørgensen, O Simonsen
Background Gabapentin (GAB) has recently been introduced for postoperative pain treatment in orthopedic surgery. As persistent postoperative pain is still a major problem in total knee arthroplasty (TKA), studies on the effect and side effects of Gabapentin in addition to the commonly used morphine (MOR), Oxynorm (OXY) and Norspan (NOR) are highly warranted. In the present study, four relevant treatment algorithms, gabapentin and morphine (GAB/MOR), gabapentin and Oxynorm (GAB/OXY), Oxynorm (OXY) and Gabapentin, Oxynorm and Norspan (GAB/OXY/NOR) were examined...
December 29, 2017: Scandinavian Journal of Pain
Tasuku Akiyama, Tsugunobu Andoh, Eiji Ohtsuka, Hiroshi Nojima, Hidekazu Ouchi, Hiroki Takahata, Yasushi Kuraishi
The antipruritic activity of gabapentin, an anticonvulsant, was studied in a mouse model of allergic itch. In mice sensitized by an extract of the salivary glands of the mosquito (ESGM), an intradermal injection of ESGM elicited scratching and increased peripheral nerve firing. Oral or intradermal administration of gabapentin at the ESGM injection site inhibited ESGM-induced scratching and peripheral nerve firing. However, gabapentin did not affect histamine-induced scratching. The distributions of immunoreactivity to the voltage-dependent calcium channel α2 δ-1 subunit, a site of gabapentin action, and the histamine H1 receptor differed in the mouse dorsal root ganglia...
May 26, 2018: European Journal of Pharmacology
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