RESUMO
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.
Assuntos
Analgésicos/administração & dosagem , Herpes Zoster/complicações , Sulfato de Magnésio/administração & dosagem , Neuralgia/terapia , Idoso , Idoso de 80 Anos ou mais , Analgésicos/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Infusões Intravenosas , Sulfato de Magnésio/efeitos adversos , Masculino , Pessoa de Meia-Idade , N-Metilaspartato/metabolismo , Neuralgia/etiologia , Medição da DorAssuntos
Analgésicos/uso terapêutico , Dronabinol/análogos & derivados , Receptores Opioides/fisiologia , Analgésicos/farmacologia , Dronabinol/farmacologia , Dronabinol/uso terapêutico , Humanos , Esclerose Múltipla/fisiopatologia , Naloxona/farmacologia , Antagonistas de Entorpecentes/farmacologia , Dor/tratamento farmacológico , Medição da Dor , Receptores Opioides/efeitos dos fármacosRESUMO
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.
