Results suggested that all therapies had little to no effect on pain and other patient-important outcomes .
Our findings are inconsistent with major clinical practice guidelines ; the available evidence suggests no beneficial effects of any therapies that research ers have evaluated in r and omized controlled trials
BACKGROUND AND PURPOSE Central poststroke pain is a chronic neuropathic disorder that follows a stroke .
Current research on its management is limited , and no review has evaluated all therapies for central poststroke pain .
Lamotrigine for central poststroke pain
Objective : Central poststroke pain ( CPSP ) is usually difficult to treat . Amitriptyline , the only oral preparation shown to be effective in a r and omized controlled trial , is often associated with a range of side effects related to the many mechanisms of actions of tricyclic antidepressants . We investigated the effect of lamotrigine , a drug that reduces neuronal hyperexcitability , on poststroke pain . Methods : Thirty consecutive patients with CPSP ( median age 59 years , range 37 to 77 ; median pain duration 2.0 years , range 0.3 to 12 ) from two centers participated in a r and omized , double-blind , placebo-controlled cross-over study . The study consisted of two 8-week treatment periods separated by 2 weeks of wash-out . The primary endpoint was the median value of the mean daily pain score during the last week of treatment while treated with 200 mg/d lamotrigine . Secondary endpoints were median pain scores while on lamotrigine 25 mg/d , 50 mg/d , and 100 mg/d ; a global pain score ; assessment of evoked pain ; areas of spontaneous pain ; and allodynia/dysesthesia . Results : Lamotrigine 200 mg/d reduced the median pain score to 5 , compared to 7 during placebo ( p = 0.01 ) in the intent-to-treat population of 27 patients . No significant effect was obtained at lower doses . Twelve patients ( 44 % ) responded to the treatment . There was a uniform tendency to reduction of all secondary outcome measures , but lamotrigine only had significant effects on some of the secondary outcome measures . Lamotrigine was well tolerated with few and transient side effects . Two mild rashes occurred during lamotrigine treatment , one causing withdrawal from study . Conclusions : Oral lamotrigine 200 mg daily is a well tolerated and moderately effective treatment for central poststroke pain . Lamotrigine may be an alternative to tricyclic antidepressants in the treatment of CPSP
Results suggested that all therapies had little to no effect on pain and other patient-important outcomes .
Our findings are inconsistent with major clinical practice guidelines ; the available evidence suggests no beneficial effects of any therapies that research ers have evaluated in r and omized controlled trials
BACKGROUND AND PURPOSE Central poststroke pain is a chronic neuropathic disorder that follows a stroke .
Current research on its management is limited , and no review has evaluated all therapies for central poststroke pain .