Open Access(225) Open Label Trial of Oxcarbazepine in Neuropathic Pain
Author(s) -
Royal Mike,
Wienecke Gretchen,
Movva Venkatesh,
Ward Sameh,
Bhakta Bhadresh,
Jensen Mike,
Gunyea Ian
Publication year - 2001
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1046/j.1526-4637.2001.01039-25.x
Subject(s) - oxcarbazepine , medicine , carbamazepine , neuropathic pain , adverse effect , anesthesia , rash , gabapentin , trigeminal neuralgia , nausea , anticonvulsant , neuralgia , erythema , vomiting , pharmacology , dermatology , epilepsy , alternative medicine , pathology , psychiatry
We evaluated the use of a new anticonvulsant, oxcarbazepine (Trileptal®, Novartis Pharmaceuticals), in 24 consecutive patients (19 females, 3 males) with neuropathic pain who were nonresponders to gabapentin (Neurontin®, Parke Davis). Oxcarbazepine was FDA‐approved in early 2000 for add‐on treatment of partial seizures in adults. It is a keto‐analog of carbamazepine that is rapidly converted to a monohydroxy derivative that is the active drug [1]. It is a membrane stabilizer and a weak hepatic induce without autoinduction. It has demonstrated comparable efficacy to carbamazepine in trigeminal neuralgia with fewer side effects [2]. Unlike carbamazepine, oxcarbazepine has no bone marrow suppression or hepatotoxicity. All patients were started on 300 mg daily and were asked to increase to 300 mg twice daily at 1 week and then further increases were made at weekly intervals as tolerated. Responses were characterized as follows: excellent (greater than 70% reduction in neuropathic symptoms), good (50–70% improvement), fair (20–50% improvement) and poor (less than 20% improvement). The following results were obtained: excellent = 12.5%, good = 20.8%, fair = 20.8%, and poor = 45.8%. Only 6 patients had mild to moderate adverse events (nausea, vomiting or dizziness in 4 patients, skin rash in 1 patient and edema in 1 patient). At the time of this report, all but 2 of the patients had not increased beyond 600 mg q.d. indicating the potential for even better response rates at higher doses, as was seen in two of the excellent responders who did not achieve their effect until 900–1200 mg. Oxcarbazepine is a well‐tolerated option for treating refractory neuropathic pain.