Opioids effctive in treatment of post-shingles neuralgia
Opioids can be used to treat postherpetic neuralgia (PHN), according
to American researchers.
They found that opioids were as effective as tricyclic antidepressants
(TCA) currently used for this indication, and that they did not affect
patients’ cognitive function. In a cross-over trial, 76 patients
with PHN were randomised to receive opioids, TCA and placebo, during three
separate eight-week treatment periods. Mean daily maintenance doses were
morphine 91mg or methadone 15mg, and nortriptyline 89mg or desipramine
63mg.
There was no difference between opioids and TCA in terms of pain relief,
but both resulted in greater pain relief than placebo (38 and 32 per cent,
respectively, versus 11 per cent, P=0.001), with no appreciable effect
on any cognitive measure.
However, more patients preferred opioids (54 per cent) than TCA (30 per
cent). The researchers say the role of opioids has been controversial
but argue that these drugs could be a useful alternative treatment for
neuropathic pain (Neurology 2002;59:1015).
|
