Treatment with either opioids or tricyclic antidepressants (TCA) is effective in treating postherpetic neuralgia (PHN) without causing cognitive impairment, according to results of a double-blind, crossover-design trial published in the Oct. 8 issue of Neurology.
“By comparing opioids to antidepressants head to head, our study suggests that opiates effectively relieve pain and are preferred by a greater proportion of patients,” lead author Srinivasa N. Raja, MD, from Johns Hopkins University in Baltimore, Maryland, says in a news release.
“This adds further evidence that opioids are a good alternative for patients not responding to other types of pain medications.” In this randomized study, 76 patients with PHN were scheduled for three treatment periods: opioid, TCA, and placebo, each lasting approximately eight weeks separated by a one-week washout period. Fifty patients completed two periods, and 44 completed all three.
Doses were adjusted to achieve maximal relief without intolerable adverse effects; mean daily maintenance doses were controlled-release morphine 91 mg or methadone 15 mg, and nortriptyline 89 mg or desipramine 63 mg. Opioids did not affect any measure of cognitive function, but TCAs slightly worsened performance on several tests.
e-Med Tools
קצר קולע וממוקד
e-Med סמינרים
אי-מד תחקירים
Medscape Tools
Journal Club
מרכזי מידע ושירות
Facebook
מידע למפרסם
מאגר תרופות
מאגר אנשי המקצוע
אינדקס שימושי
חדשות משה"ב
eMed HealthClub
מחקרים קליניים
השאירו תגובה
רוצה להצטרף לדיון?תרגישו חופשי לתרום!