Document Detail


A placebo-controlled trial of lamotrigine for painful HIV-associated neuropathy.
MedLine Citation:
PMID:  10851374     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the analgesic efficacy of lamotrigine in the treatment of painful HIV-associated distal sensory polyneuropathy (DSP).
BACKGROUND: The pathogenesis of HIV-associated DSP is unknown and there is no effective treatment. A novel anticonvulsant, lamotrigine, blocks voltage-sensitive sodium channels and inhibits the release of glutamate and aspartate. There have been anecdotal reports of efficacy of lamotrigine in the treatment of painful neuropathy and trigeminal neuralgia.
METHODS: In a multicenter, randomized, double-blind, placebo-controlled study, lamotrigine was initiated at 25 mg per day and slowly titrated over 7 weeks to 300 mg per day. Study duration was 14 weeks. The primary outcome measure was change in pain on the modified Gracely scale with secondary outcome measures including change in neurologic examination, use of concomitant analgesic medications, and global pain relief.
RESULTS: Of 42 enrolled subjects, 13 did not complete the 14-week study endpoint. In five of these, rash was the cause for dropout. In the remaining 29 evaluable subjects, 20 patients received placebo and 9 received lamotrigine. The pain scores at baseline were not significantly different. The reduction in average pain from baseline to week 14 was greater (p = 0.03) in the lamotrigine group (-0.55) than in the placebo group (-0.18), adjusting for baseline levels of pain. There was no difference between the groups on the change in peak worst pain.
CONCLUSIONS: In this small trial, lamotrigine showed promise in the treatment of pain associated with HIV-related DSP. The frequency of rash was greater than in lamotrigine studies in epilepsy. A larger controlled study of lamotrigine is warranted.
Authors:
D M Simpson; R Olney; J C McArthur; A Khan; J Godbold; K Ebel-Frommer
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Neurology     Volume:  54     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-07-13     Completed Date:  2000-07-13     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2115-9     Citation Subset:  AIM; IM; X    
Affiliation:
Mount Sinai Medical Center, New York, NY 10029, USA. david.simpson@mssm.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesics / adverse effects,  therapeutic use*
Analysis of Variance
Double-Blind Method
Drug Eruptions / etiology
Exanthema / chemically induced
Female
HIV Infections / complications,  drug therapy*
Humans
Male
Middle Aged
Neuralgia / drug therapy*
Polyneuropathies / drug therapy*,  etiology
Triazines / adverse effects,  therapeutic use*
Grant Support
ID/Acronym/Agency:
RR00722/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Analgesics; 0/Triazines; U3H27498KS/lamotrigine
Comments/Corrections
Comment In:
Neurology. 2000 Jun 13;54(11):2037-8   [PMID:  10851359 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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