High‐dose oral dextromethorphan versus placebo in painful diabetic neuropathy and postherpetic neuralgia

@article{Nelson1997HighdoseOD,
  title={High‐dose oral dextromethorphan versus placebo in painful diabetic neuropathy and postherpetic neuralgia},
  author={K. A. Nelson and K. M. Park and E. Robinovitz and C. Tsigos and M. Max},
  journal={Neurology},
  year={1997},
  volume={48},
  pages={1212 - 1218}
}
N-methyl-D-aspartate (NMDA) receptor antagonists relieve neuropathic pain in animal models, but side effects of dissociative anesthetic channel blockers, such as ketamine, have discouraged clinical application. Based on the hypothesis that low-affinity NMDA channel blockers might have a better therapeutic ratio, we carried out two randomized, double-blind, crossover trials comparing six weeks of oral dextromethorphan to placebo in two groups, made up of 14 patients with painful distal… Expand
Dextromethorphan and Memantine in Painful Diabetic Neuropathy and Postherpetic Neuralgia: Efficacy and Dose-Response Trials
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References

SHOWING 1-10 OF 53 REFERENCES
Efficacy of desipramine in painful diabetic neuropathy: a placebo-controlled trial
TLDR
Desipramine relieves pain in many patients with painful diabetic neuropathy, offering an alternative for patients unable to tolerate amitriptyline, and blockade of norepinephrine reuptake may mediate this analgesic effect. Expand
Relief of post-herpetic neuralgia with the N-methyl-d-aspartic acid receptor antagonist ketamine: A double-blind, cross-over comparison with morphine and placebo
TLDR
The hypothesis that the Symbol (NMDA) receptors are involved in the control of post‐herpetic neuralgia including allodynia and wind‐up‐like pain and the NMDA receptors also may play a role in the modulation of thermal perception is supported. Expand
Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy.
TLDR
Desipramine relieves pain caused by diabetic neuropathy with efficacy similar to that of amitriptyline, offering an alternative for patients unable to tolerate the latter and blockade of norepinephrine reuptake is likely to mediate the analgesic effect of these antidepressant drugs in diabetic Neuropathy. Expand
Response of chronic neuropathic pain syndromes to ketamine: a preliminary study
TLDR
Ketamine affected the evoked pain and associated after‐sensation in chronic neuropathic pain syndromes more than the ongoing constant pain. Expand
Transdermal clonidine compared to placebo in painful diabetic neuropathy using a two-stage ‘enriched enrollment’ design
TLDR
The hypothesis that there is a subset of patients with painful diabetic neuropathy who benefit from systemic clonidine administration is supported and the value of an enriched enrollment technique in analgesic trials is illustrated. Expand
Intravenous infusion of the NMDA antagonist, ketamine, in chronic posttraumatic pain with allodynia: a double-blind comparison to alfentanil and placebo.
TLDR
It is concluded that NMDA antagonists may have promise for the treatment of neuropathic pain, but strategies are needed to improve their therapeutic ratio, such as intrathecal administration or systemic treatment with more selective drugs. Expand
Dextromethorphan for the treatment of neuropathic pain: a double-blind randomised controlled crossover trial with integral n-of-1 design
TLDR
There were no significant differences between DM and placebo on any of the clinic assessment outcome measures, and two patients had significantly better analgesia on more than one outcome measure on within‐patient testing. Expand
Desipramine relieves postherpetic neuralgia.
TLDR
It is concluded that desipramine administration relieves postherpetic neuralgia and that pain relief is not mediated by mood elevation, and blockade of norepinephrine reuptake, an action shared by desIPramine, amitriptyline, and other antidepressant agents that have relieved neuropathic pain, may be involved in relief of postherPetic Neuralgia. Expand
Intravenous lidocaine infusion — a new treatment of chronic painful diabetic neuropathy?
In a randomized double-blind, cross-over study the effect of intravenous lidocaine (5 mg/kg body weight) on the symptoms and signs of painful diabetic neuropathy of more than 6 months duration hasExpand
The selective serotonin reuptake inhibitor citalopram relieves the symptoms of diabetic neuropathy
TLDR
Compared with earlier results obtained with imipramine administered on the basis of plasma level monitoring, citalopram appeared to be less effective, but seemed to be better tolerated. Expand
...
1
2
3
4
5
...