A Comparative Study on Efficacy and Safety for Management of Neuropathic Pain with Gabapentin, Pregabalin and Amitriptyline
- 1. Assistant Professor, Dept. of Neurology, GSVM Medical College Kanpur
- 2. Professor, Dept. of Neurology, GSVM Medical College Kanpur
- 3. Assistant Professor, Dept. Of Pharmacology, GSVM Medical College Kanpur
Description
Introduction: Current treatment for neuropathic pain (NeP) are tricyclic antidepressants (TCA), gabapentin and pregabalin as first-line treatment for the most common NeP conditions. Current therapy for the treatment of neuropathic pain is often unsatisfactory. Considerable variation in treatment pattern still exists in spite of availability of sufficient literature from various guidelines. Recent Indian market data suggested that the utilization (sale) of drugs such as amitriptyline, pregabalin, and gabapentin is actually recommended in the guidelines. Methods: It is a prospective, comparative, open label, single centre, three arm study. A total of 300 patients diagnosed with cases of chronic lumbar radiculopathy based on symptoms, clinical examination, X-ray and MRI scan of lumbosacral spine, were randomized into three groups to receive Group A patients received Gabapentine 300 mg, Group B patients received Pregabaline 75 mg, Group C patients received Amitriptyline 10 mg. Patients were assessed for pain relief by using visual analogue scale and an overall improvement in their general condition by patient’s global impression of change scale. Adverse drug reactions were recorded on each follow up. Results: All patients had significant improvement in pain relief in three treatment groups. The mean Numeric pain rating scale (NPRS) score At 2 months, the Mean±SD of NPRS score in Group A was 3.72±2.65, in Group B and Group C were 3.63±2.65 and 5.21±2.65 respectively with F-value of 6.63 and p-value of 0.001 which was statistically significant. Intergroup comparison shows significant differences among three the treatment groups. The adverse effects reported occurrence of dizziness was significantly more in group B with 21 patients (23.33%) as compared to group A with 11 patients (12.22%) and group C with 4 patients (4.44%), [p=0.041). The sedation occurred in 28 patients of group B (31.11%), which was significantly more than group A i,e, in 23 patients (25.55%) and group C i.e. 22 patients (24.44%), [P=0.036]. Conclusions: In patients with NeP Thus, in conclusion three groups Gabapentine, Pregabaline and Amitriptyline are equally efficacious in relieving pain in NeP. Pregabalin has the advantages in terms of Numeric pain rating scale (NPRS) score over the Gabapentine and Amitriptyline. Gabapentine has fewer reported adverse effects and hence a better patient compliance on long term use.
Abstract (English)
Introduction: Current treatment for neuropathic pain (NeP) are tricyclic antidepressants (TCA), gabapentin and pregabalin as first-line treatment for the most common NeP conditions. Current therapy for the treatment of neuropathic pain is often unsatisfactory. Considerable variation in treatment pattern still exists in spite of availability of sufficient literature from various guidelines. Recent Indian market data suggested that the utilization (sale) of drugs such as amitriptyline, pregabalin, and gabapentin is actually recommended in the guidelines. Methods: It is a prospective, comparative, open label, single centre, three arm study. A total of 300 patients diagnosed with cases of chronic lumbar radiculopathy based on symptoms, clinical examination, X-ray and MRI scan of lumbosacral spine, were randomized into three groups to receive Group A patients received Gabapentine 300 mg, Group B patients received Pregabaline 75 mg, Group C patients received Amitriptyline 10 mg. Patients were assessed for pain relief by using visual analogue scale and an overall improvement in their general condition by patient’s global impression of change scale. Adverse drug reactions were recorded on each follow up. Results: All patients had significant improvement in pain relief in three treatment groups. The mean Numeric pain rating scale (NPRS) score At 2 months, the Mean±SD of NPRS score in Group A was 3.72±2.65, in Group B and Group C were 3.63±2.65 and 5.21±2.65 respectively with F-value of 6.63 and p-value of 0.001 which was statistically significant. Intergroup comparison shows significant differences among three the treatment groups. The adverse effects reported occurrence of dizziness was significantly more in group B with 21 patients (23.33%) as compared to group A with 11 patients (12.22%) and group C with 4 patients (4.44%), [p=0.041). The sedation occurred in 28 patients of group B (31.11%), which was significantly more than group A i,e, in 23 patients (25.55%) and group C i.e. 22 patients (24.44%), [P=0.036]. Conclusions: In patients with NeP Thus, in conclusion three groups Gabapentine, Pregabaline and Amitriptyline are equally efficacious in relieving pain in NeP. Pregabalin has the advantages in terms of Numeric pain rating scale (NPRS) score over the Gabapentine and Amitriptyline. Gabapentine has fewer reported adverse effects and hence a better patient compliance on long term use.
Files
IJPCR,Vol14,Issue11,Article110.pdf
Additional details
Dates
- Accepted
-
2022-11-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue11,Article110.pdf
- Development Status
- Active
References
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