News - Neuropathy Pain Med - Topiramate

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Topiramate Shows Promise for Treatment of Neuropathy and Chronic Pain

NEW YORK (Reuters Health) Feb 08 - The anti-epileptic drug topiramate

may be an effective addition to the arsenal of agents used to treat

neuropathic and sympathetically maintained pain,researchers in Oklahoma

report.

Dr. G. Jenson and associates, of the Pain Evaluation and

Treatment Center in Tulsa, treated 61 patients with topiramate. Patient

conditions included reflex sympathetic dystrophy, migraine and cluster

headaches, radiculopathy, discogenic disease, phantom limb pain, and

pain resulting from skin graft and third-degree burns, in addition to

diabetic and other types of neuropathies.

Dosing was initiated at 25 mg at bedtime. As the investigators report in

the American Journal of Pain Management for January, they titrated doses

upward at weekly intervals until efficacy was demonstrated or to a

maximum of 400 mg/day.

More than half of the patients had a greater than 50% improvement in

symptoms. A greater than 70% reduction in symptoms was experienced by

14.6%. Only 12.2% experienced a poor response.

The lowest dose at which patients experienced relief was 50 mg, while

seven patients were titrated up to 400 mg. A mean of 131 mg was the

average effective dose. Two patients discontinued use of the drug

because of nausea, and another 16 because of dizziness and sedation.

Dr. Jenson and his colleagues note that the 15- and 25-mg dosage forms

make topiramate easy to titrate, which enhances tolerability.

From: Am J Pain Manage 2002;12:16-23.