Abstract

CANOVAS, L. et al. Effects of duloxetin and amitriptilin in neurophatic pain: Study in 180 patients. Rev. Soc. Esp. Dolor [online]. 2007, vol.14, n.8, pp.568-573. ISSN 1134-8046.

Objective. Evaluation of analgesia efficacy and tolerability of duloxetine versus amitriptyline in neuropathic pain. Methods. Prospective study in 180 patients during three months. We excluded patients with anxiety or depression. The patients were distributed in three groups: A (30 mg duloxetine at dinner, in the third day 60 mg, increasing 30 mg a week until relief pain); B (60 mg duloxetine at dinner, increasing 30 mg a week until relief pain); C (>60 years: 10 mg amitriptyline and <60 years 25 mg amitriptyline at dinner, increasing 25 mg a week until relief pain). We study: Age, diagnose, duration and severity pain (VAS), analgesia efficacy, time until relief pain, analgesic dose, adverse events (frequency, duration and severity), satisfaction of patient. The patients were evaluated a week, fifteen days, a month and three months. The student t test and binomial model was used for statistical comparison. Results. We studied: lumbar radiculopathy (45%), cervical radiculopathy (23%), postherpetic neuralgia (11.5%), trigeminal neuralgia (10%), Complex Regional Pain syndrome I (5%), postsurgical neuropathic pain (5.5%). In A and B groups the pain relief in a week of treatment, in C group after 15 days of treatment. The time until relief pain were: A 5±2, B 6±1, C 14±6 days; the analgesic doses were: A 65±24 mg, B 67±22 mg, C 35±32 mg. The frequency of adverse events was more significant in the group amitriptyline (dry mouth, constipation, orthostatic hypotension) versus duloxetine (nausea, somnolence). Adverse events in the patients of the group A were weight. The personal satisfaction was excellent/good in 95.6% patients included in groups A and B, and 78.7% in groups C. Conclusions. Duloxetine and amitriptyline are effective in neuropathic pain. Less time until relief pain and less adverse events with duloxetine. The beginning of treatment with 30 mg duloxetine decrease events adverse.

Keywords : duloxetine; amitriptyline; antidepressants; neuropathic pain; adverse events.

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