Ziconotide (Prialt): an innovative alternative for intense chronic neuropathic pain

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Rev Neurol. 2007 Dec 1-15;45(11):665-9.

Ziconotide: an innovative alternative for intense chronic neuropathic

pain

Valía-Vera JC, Villanueva VL, Asensio-Samper JM, López-Alarcón MD, de

Andrés JA.

Servicio de Anestesia, Reanimación y Terapéutica del Dolor, Unidad

Multidisciplinar de Tratamiento del Dolor, Consorcio Hospital General

Universitario de Valencia, Valencia, Espana.

INTRODUCTION: Intense chronic pain is a very important health

problem, as it has a high prevalence (5-10%), a multifactorial

aetiology and its management is very often a very complex affair.

Treatment of severe cases sometimes requires interventional

approaches, such as continuous intrathecal infusion of opioids.

CASE REPORT: We report the case of a 38-year-old female with intense

neuropathic pain in the lower back and the lower limbs secondary to

three operations on the L5-S1 lumbar segment. After implementing

several different pharmacological regimes involving both oral and

implanted systems (spinal cord stimulation and subarachnoid infusion

pump with different pharmacological combinations) with no clinical

improvement, intrathecal infusion with ziconotide was included in the

protocol.

CONCLUSIONS: Ziconotide is the first specific neuronal blocker that

acts on the calcium channel by blocking the N-type voltage-dependent

calcium channels. It is a new non-opioid analgesic with approved

indication in the treatment of intense chronic pain, in patients who

require intrathecal analgesics and are refractory to other analgesic

treatments. Therefore, we shall have to consider this drug as a

therapeutic alternative in patients do not experience sufficient

relief with the pharmacological agents and means currently available

to treat them.

More on Ziconotide (Prialt) at http://en.wikipedia.org/wiki/Ziconotide