To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: ANA: Lamotrigine Controls Pain In Patients With Polyneuropathy URL: http://www.pslgroup.com/dg/207A06.htm Doctor's Guide October 2, 2001
By Ed Susman Special to DG News
CHICAGO, IL -- October 2, 2001 -- Treatment of multiple neuropathy sites, a common problem among patients who have diabetes, can be achieved with the anti-convulsant drug lamotrigine.
Lamotrigine was more effective than placebo in reducing pain scores recorded on visual analog scales, according to David E. Hart, MD, of Upstate Neurology Consultants and a clinical assistant professor of medicine at Albany Medical College, in Albany, New York, who presented the findings yesterday (Oct. 1) at the 126th annual meeting of the American Neurological Association, in Chicago, Illinois.
Dr. Hart demonstrated that patients treated with a placebo reduced their visual analog scores from an average of 70 to an average of 50; while patients receiving lamotrigine reduced scores from an average of 75 to less than 30. The difference between the two groups was statistically significant, he said.
"A score of 70 or 75 on visual analog scales," Dr. Hart said, "are indications that the pain is severe and interferes with a person's activities of daily living. A score of 30 is a pain level that may be annoying but not greatly limiting one's quality of life."
Dr. Hart and his colleagues considered that lamotrigine, which appears to be active at neuronal sodium channels, might also be active in treating painful polyneuropathy.
He recruited 21 adults with polyneuropathy and assigned 13 to receive a target dose of 200 mg a day of lamotrigine and eight to receive placebo. Those without adequate pain control were titrated to a maximum of 500 mg.
Patients completed the Short Form McGill Pain Questionnaire/Visual Analog Scale (VAS) at each of seven office visits and completed pain and sleep disturbance diaries daily.
Lamotrigine-treated patients had significantly lower mean visual analog scores than placebo-treated patients at visits 6 and 7. Dr. Hart said the patients tolerated the study medication well.
"Lamotrigine appears to be an effective and well-tolerated treatment for painful polyneuropathy," Dr. Hart said, noting that larger trials to confirm his finding are warranted.
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