Neuropathic pain assessment

Multidimensional assessment tools obtain information about the pain and impact on quality of life, but are often more time-consuming to complete. Examples of these types of tools include the Initial Pain Assessment Tool, Brief Pain Inventory, McGill Pain Questionnaire, the Neuropathic Pain Scale, and the Oswestry Disability Index.29-33... 

Milnacipran is currently available for use as an antidepressant in several countries outside the U.S. It is also under clinical development to assess its potential role in the treatment of fibromyalgia syndrome [62,63]. In a rat model of neuropathic pain, milnacipran, administered intrathecally, produced dose-dependent anti-allodynic effects at doses between 3 and 100 gg for up to 7h [64], The anti-allodynic effect of 30 gg of milnacipran was attenuated by intrathecal coadministration of a serotonin receptor antagonist or a norepinephrine receptor... 

The safety and efficacy of gabapentin as adjunctive therapy to CBZ and/or phenytoin has been assessed in adults, adolescents (Bruni, 1998), and children (Khur-ana et ah, 1996) with partial seizures. A decrease of 50% or more in frequency of complex partial -I- secondary generalized seizures was reported in 71% of patients on a mean maintenance dose of gabapentin of 1600 mg/day (Bruni, 1998). It has also been used in the treatment of spasticity in adolescents with multiple sclerosis (Cutter et al., 2000) and in adults and adolescents with neuropathic pain (Rosenberg et al.,... 

Argoff CE, Galer BS, Jensen MP, et al. Effectiveness of the lidocaine patch 5% on pain qualities in three chronic pain states assessment with the Neuropathic Pain Scale. CurrMed Res Opin. 2004 20(suppl 2) S21-S28. 

The cause of the pain should first be assessed. A tricyclic antidepressant is appropriate for neuropathic pain due to neoplastic extension to peripheral nerves, a corticosteroid for nerve entrapment, an opioid for a liver distended with metastatic disease, a NSAID for bony secondaries. 

Compound 104 was shown to be a potent, selective, and reversible non-covalent FAAH (fatty acid amide hydrolase) inhibitor for the treatment of inflammatory and neuropathic pain. With respect to other inhibitors proposed before, the peculiarities that make it so effective and promising are the reversible binding with the FAAH and the replacement of the classical and weU-assessed pyrazole ring with an oxazole ring (14AMCL717). 

Placebo-controlled studies The use of tramadol in neuropathic pain after spinal cord injury has been assessed in a double-blind, randomized, placebo-controlled study in 35 patients [186 ]. There were moderate to severe adverse events in 91% of patients on tramadol and 58% of those on placebo 48% of those taking tramadol were withdrawn from the study because of adverse events. The most common adverse events were tiredness, dry mouth, and dizziness. 

Backomja MM, Galer BS. Pain assessment and evaluation of patients who have neuropathic pain. Neurol Clin 1998 16 775-789. 

Baron T, ToUe R. Assessment and diagnosis of neuropathic pain. Curr Opin Support Palliat Care 2008 2 1-8. 

Diabetic peripheral neuropathic pain the effectiveness of duloxetine must be assessed carefully based on the progress of diabetic peripheral neuropathy. 

Grond, S. Radbruch, L. Meuser, T. Sabatowsld, R. Loik, G. Lehmann, K. Assessment and treatment of neuropathic cancer pain following WHO guidelines. Pain 1999, 79 (1), 15-20. 

Observational studies The usefulness of gabapentin in combination with opioids in 24 Japanese patients with neuropathic cancer pain has been assessed in an open prospective study [155 ]. Gabapentin was added to opioid therapy in an initial dose of 200 mg/day titrated to a maximum dose of 2400 mg/day over 15 days. Gabapentin reduced the score on a pain scale, but the reduction was of minimal clinical benefit. Four patients withdrew because of adverse events headache, myoclonus, heartburn, and an attack of bronchial asthma). Only a few patients reported somnolence or dizziness, and these symptoms did not require drug withdrawal. 

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