Neuropathic pain affects more than 20 million people in the U.S., and at least a quarter of these cases are puzzling for doctors. These unexplained cases are called cryptogenic sensory polyneuropathy (CSPN), where the cause of the nerve pain remains unknown.
For people with CSPN, finding effective treatment can be challenging because there isn’t enough information available to help doctors choose the best medications.
To tackle this issue, scientists at the University of Missouri recently conducted a large study comparing four common drugs used for treating CSPN. Their goal was to see which medications might work best for easing nerve pain.
The study included 402 patients, all aged 30 or older, who were experiencing significant pain. Each participant rated their pain at a level of four or higher on a 10-point scale, indicating a high level of discomfort.
Participants were prescribed one of four drugs: nortriptyline, duloxetine, pregabalin, or mexiletine. Each drug works differently.
Nortriptyline is an antidepressant that belongs to the tricyclic class, duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI), pregabalin is typically used to prevent seizures, and mexiletine is an anti-arrhythmic medication that helps control heart rhythm but is sometimes used for nerve pain.
Over 12 weeks, doctors assessed how well each drug was helping with pain relief and tracked how many patients continued or stopped the treatment.
The results showed that nortriptyline had the highest success rate, with 25% of patients experiencing effective pain relief. It also had a relatively low quit rate of 38%. Duloxetine was close behind with a 23% success rate and the lowest drop-out rate at 37%.
Pregabalin had the least success, with only 15% of patients finding relief, and mexiletine had the highest quit rate, with 58% of patients choosing to stop the medication.
Even though none of the drugs showed outstanding results across all patients, nortriptyline and duloxetine stood out as the most promising options when both pain relief and patient continuation were considered.
Based on these findings, the researchers suggest that doctors may want to consider nortriptyline or duloxetine as initial treatment options for patients with CSPN.
It’s worth noting that other drugs, like gabapentin and venlafaxine, as well as some sodium channel inhibitors, are also used to manage nerve pain.
The researchers believe more studies should examine these additional drugs, which could give doctors more options to treat CSPN and help them make informed choices for their patients.
This study represents a significant step toward finding more effective treatments for CSPN. As more research is done, doctors may eventually have a solid set of guidelines to help them treat this challenging condition.
The findings were published in JAMA Neurology and led by Dr. Richard Barohn and his team.
If you care about arthritis, please read studies about extra virgin olive oil for arthritis, and pomegranate: A natural treatment for rheumatoid arthritis.
For more information about arthritis, please see recent studies about how to live pain-free with arthritis, and results showing medical cannabis may help reduce arthritis pain, back pain.
Copyright © 2024 Knowridge Science Report. All rights reserved.
