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Trazodone for deafferentation pain. Comparison with amitriptyline
V Ventafridda1, A Caraceni, L Saita
1Division of Pain Therapy, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy.
Psychopharmacology
|January 1, 1988
Summary
Trazodone and amitriptyline show similar effectiveness in managing chronic deafferentation pain, particularly from cancer nerve damage. This study compared their impact on pain, sleep, and mood in patients previously treated with opioids.
Area of Science:
- Pain Management
- Neurology
- Pharmacology
Background:
- Chronic pain from deafferentation, often due to oncological peripheral nerve lesions, presents a significant clinical challenge.
- Patients frequently have inadequate pain relief despite treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and opioids.
Purpose of the Study:
- To evaluate and compare the efficacy of trazodone and amitriptyline in treating chronic deafferentation pain.
- To assess the impact of these antidepressants on pain intensity, sleep quality, functional capacity, mood, and anxiety.
Main Methods:
- A randomized, double-blind, multicenter clinical study involving 45 patients with deafferentation pain.
- Patients were randomly assigned to receive either trazodone (23 patients) or amitriptyline (22 patients).
- Outcomes measured included pain intensity, sleep duration, functional status (standing/lying hours), mood, anxiety, and side effects.
Main Results:
- Both trazodone and amitriptyline demonstrated similar therapeutic analgesic efficacy in the treatment of deafferentation pain.
- The study considered various parameters including pain intensity, sleep, functional capacity, mood, anxiety, and side effects.
Conclusions:
- Trazodone and amitriptyline are comparable in their effectiveness for managing chronic deafferentation pain.
- These antidepressant agents offer a potential treatment option for patients with difficult-to-treat pain, especially those with neuropathic pain from cancer.