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Comparison of the Effectiveness of Amitriptyline and Gabapentin on Chronic Neuropathic Pain in Persons With Spinal Cord Injury  Diana H. Rintala, PhD,

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Presentation on theme: "Comparison of the Effectiveness of Amitriptyline and Gabapentin on Chronic Neuropathic Pain in Persons With Spinal Cord Injury  Diana H. Rintala, PhD,"— Presentation transcript:

1 Comparison of the Effectiveness of Amitriptyline and Gabapentin on Chronic Neuropathic Pain in Persons With Spinal Cord Injury  Diana H. Rintala, PhD, Sally Ann Holmes, MD, Daisy Courtade, MA, Richard Neil Fiess, Luz Viviana Tastard, MD, Paul G. Loubser, MD  Archives of Physical Medicine and Rehabilitation  Volume 88, Issue 12, Pages (December 2007) DOI: /j.apmr Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

2 Fig 1 Profile of the study. There were 6 random assignment groups that differed only with respect to the order in which the medications were received. Twenty-two completed all 3 phases; 26 completed the gabapentin phase, 28 the amitriptyline phase, and 25 the diphenhydramine phase. Abbreviations: A, amitriptyline; D, diphenhydramine; G, gabapentin. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

3 Fig 2 Means and error bars (±2 standard error) of VAS ratings of pain intensity on average during week 8 of each medication by the 22 participants who completed all 3 phases of the study (completers) within the depressive symptomatology groups. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

4 Fig 3 Mean pain intensity ratings on the VAS across time for each study medication within the depressive symptomatology groups. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

5 Fig 4 Mean pain intensity ratings on the NRS across time for each study medication within the depressive symptomatology groups. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

6 Fig 5 Mean decrease in average pain intensity ratings on the VAS from baseline to week 8 of each medication within the depressive symptomatology groups. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

7 Fig 6 Mean percent change in average pain intensity ratings on the VAS from baseline to week 8 of each medication within depressive symptomatology groups. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

8 Fig 7 Mean CESD-SF scores across time for each medication within the depressive symptomatology groups. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

9 Fig 8 Dropout rate across time for each medication.
Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

10 Fig 9 Average pain intensity ratings on the VAS during amitriptyline treatment by the 22 completers and by all available ratings for amitriptyline at each time point. Sample sizes for the “All” points varied depending on dropout and early withdrawal rates. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

11 Fig 10 Average pain intensity ratings on the VAS during gabapentin treatment by the 22 completers and by all available ratings for gabapentin at each time point. Sample sizes for the “All” points varied depending on dropout and early withdrawal rates. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

12 Fig 11 Average pain intensity ratings on the VAS during diphenhydramine treatment by the 22 completers and by all available ratings for diphenhydramine at each time point. Sample sizes for the “All” points varied depending on dropout and early withdrawal rates. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

13 Fig 12 Average pain intensity ratings on the VAS for week 8 by the order in which each medication was received according to randomly assigned group. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

14 Fig 13 Frequency distribution of the number of oxycodone-acetaminophen tablets taken for breakthrough pain during week 8 for each medication within the depressive symptomatology groups. Archives of Physical Medicine and Rehabilitation  , DOI: ( /j.apmr ) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

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