Pain
Conditions
Brief summary
Mechanism-based choice of therapy for neuropathic pain: Can treatments success in neuropathic post-operative pain be coupled to psychophysical pain modulation profile?
Detailed description
Neuropathic or idiopathic pain patients will be assessed with the variety of pain tests including the conditioned pain modulation (CPM) and temporal summation (TS). Then, they will be offered on the double-blind design a several weeks treatment with either pregabalin or duloxetine. Patients will be followed-up weekly by phone for their pain relief and will be re-assessed in the lab toward the end of the treatment. The investigators suggest that patients with less-efficient CPM (deficient pain inhibition) will earn more pain relief from the treatment with duloxetine, while the patients with the enhanced pain summation will response better to pregabalin.
Interventions
DRUGPregabalin
Initial dose of 75x2mg/d for one week, and then fixed dose of 150x2mg/d for the following 5 weeks
DRUGDuloxetine
Initial dose of 30 mg/d will be given for one week, in order to minimize possible side effects and drop outs, and then a fixed dose of 60 mg/d will be given for additional 5 weeks
Sponsors
Rambam Health Care Campus
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* patients planned for thoracotomy
Exclusion criteria
* age below 18 and above 75 years * patients with psychiatric or cognitive dysfunction precluding use of psychophysics * those who cannot communicate in Hebrew * patients with existing thoracic or other current chronic pain
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| clinical pain | One year | The pain relief will be achieved by treatment with duloxetine or pregabalin. We propose that the patients with deficient pain inhibition (As assessed by conditioned pain modulation lab test) will have better drug efficacy of cymbalta which restores the deficient level of serotonin and noradrenalin. In turn, pregabalin will be more effective in patients with enhance central sensitization of pain as measured by temporal summation assessment. In line, CPM and TS will be modulated by the treatment, in parallel with the analgesic effect. |
Countries
Israel
Outcome results
None listed