Lamotrigine for intractable sciatica: correlation between dose, plasma concentration and analgesia

An open trial was conducted to study the potential efficacy of the antiepileptic agent lamotrigine in relieving the sciatic pain and the relationship between lamotrigine dosage, plasma concentration and the clinical response. Subsequent to a 1 week washout period from previous analgesics, lamotrigin...

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Bibliographic Details
Published in:European journal of pain 2003-01, Vol.7 (6), p.485-491
Main Authors: Eisenberg, Elon, Damunni, Gassan, Hoffer, Erica, Baum, Yelena, Krivoy, Norberto
Format: Article
Language:English
Subjects:
Adult
Aged
Analgesia
Analgesics - administration & dosage
Analgesics - blood
Anticonvulsants
Anticonvulsants - administration & dosage
Anticonvulsants - blood
Dose-Response Relationship, Drug
Female
Humans
Hyperexcitability
Male
Middle Aged
Neuropathic pain
NMDA
Pain Measurement
Radiculopathy
Sciatica - drug therapy
Surveys and Questionnaires
Triazines - administration & dosage
Triazines - blood
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Summary:An open trial was conducted to study the potential efficacy of the antiepileptic agent lamotrigine in relieving the sciatic pain and the relationship between lamotrigine dosage, plasma concentration and the clinical response. Subsequent to a 1 week washout period from previous analgesics, lamotrigine dose was titrated on a weekly basis from 25 to 400 mg/day and was maintained at that dose for additional 4 weeks. Spontaneous pain, the Short Form McGill Pain Questionnaire (SFMPQ), the Straight Leg Raise (SLR) test, and range of motion of the lumbar spine (leaning foreword, to the affected side) were used to assess lamotrigine efficacy. Lamotrigine plasma concentration was tested at the end of each week during the titration period and at the end of the study. Fourteen patients were enrolled in the study. All outcome measurers improved compared to baseline during the titration period, but reached a statistically significant level of improvement only at the 400 mg dose. A linear correlation was found between mean lamotrigine dose, mean plasma concentration and mean weekly spontaneous pain, mean SLR and mean bending the affected side, but not with the SFMPQ score. Study results suggest lamotrigine is a potentially effective and safe compound for the treatment of painful lumbar radiculopathy, and that it is likely to act in a dose- and plasma concentration-dependent fashion.
ISSN:1090-3801
1532-2149
DOI:10.1016/S1090-3801(03)00020-X