ABSTRACT
BACKGROUND: Postherpetic neuralgia is a complication of acute herpes zoster characterized by severe pain and paraesthesia in the skin area affected by the initial infection. There is evidence that the N-methyl-D-aspartate receptor is involved in the development of hypersensitivity states and it is known that magnesium blocks the N-methyl-D-aspartate receptor. METHOD: A double-blind, placebo-controlled, cross-over study was conducted in which magnesium sulphate was administered as an i.v. infusion. Spontaneous pain was recorded and qualitative sensory testing with cotton wool was performed in seven patients with postherpetic neuralgia before and after the i.v. administration of either magnesium sulphate 30 mg kg(-1) or saline. RESULTS: During the administration, pain scores were significantly lower for magnesium compared with placebo at 20 and 30 min (P=0.016) but not at 10 min. I.V. magnesium sulphate was safe, well-tolerated and effective in patients with postherpetic neuralgia. CONCLUSION: The present study supports the concept that the N-methyl-D-aspartate receptor is involved in the control of postherpetic neuralgia.
Subject(s)
Analgesics/administration & dosage , Herpes Zoster/complications , Magnesium Sulfate/administration & dosage , Neuralgia/therapy , Aged , Aged, 80 and over , Analgesics/adverse effects , Double-Blind Method , Female , Humans , Infusions, Intravenous , Magnesium Sulfate/adverse effects , Male , Middle Aged , N-Methylaspartate/metabolism , Neuralgia/etiology , Pain MeasurementSubject(s)
Analgesics/therapeutic use , Dronabinol/analogs & derivatives , Receptors, Opioid/physiology , Analgesics/pharmacology , Dronabinol/pharmacology , Dronabinol/therapeutic use , Humans , Multiple Sclerosis/physiopathology , Naloxone/pharmacology , Narcotic Antagonists/pharmacology , Pain/drug therapy , Pain Measurement , Receptors, Opioid/drug effectsABSTRACT
Sodium channel antagonists have been used in the management of neuropathic pain for several years. Recent evidence suggests that lamotrigine, which is active at glutaminergic excitatory synapses, is very effective in producing pain relief. We have successfully used lamotrigine in two patients suffering from neuropathic pain. Our results suggest that this novel channel antagonist can be used to treat neuropathic pain. Double blind placebo control studies are therefore needed to substantiate these findings.
