Magazine article Clinical Psychiatry News

Add Lidocaine Patch to Gabapentin for Pain Relief. (Somnolence Is Most Common Adverse Event)

Magazine article Clinical Psychiatry News

Add Lidocaine Patch to Gabapentin for Pain Relief. (Somnolence Is Most Common Adverse Event)

Article excerpt

NEW ORLEANS -- The lidocaine patch improved pain relief for patients with postherpetic neuralgia, diabetic neuropathy, and low back pain in a study presented at the annual meeting of the American Academy of Pain Medicine.

The 2-week, open-label, multicenter pilot study showed that addition of the lidocaine patch 5% to a gabapentin regimen significantly reduced pain intensity, improved pain relief, and reduced interference of pain with activities of daily living.

The results support the idea of "rational polypharmacy," which combines a peripheral nervous system agent with a CNS agent. The CNS agent, gabapentin, is the most frequently used anticonvulsant for neuropathic pain states, according to Carey Aron, D.V.M., clinical liaison for Endo Pharmaceuticals, Chadds Ford, Pa.

"Last year the company made a decision to do open-label, real-world studies [in patient populations in which] people were reporting success with the patch," Dr. Aron said. "So we compared patients with postherpetic pain, diabetic neuropathy, and low back pain."

The study included 107 participants. There were 11 people with postherpetic neuralgia pain, 49 with diabetic neuropathy, and 47 reporting low back pain. The first group was intentionally small because postherpetic neuralgia pain relief is the Food and Drug Administration indication for the agent, so the most is already known about use of the patch in those patients.

All patients were 18 years of age or older and reported a partial response to their current regimen containing gabapentin. A partial response was defined as an average daily pain intensity of greater than 4 out of 10 on the Brief Pain Inventory (BPI), normal motor strength, normal responses to sensory testing, and normal deep tendon reflexes. The study population was 54% female, 84% white, and 16% African American. …

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