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. 2010 Apr 1:3:33-49.
doi: 10.2147/jpr.s8675.

An open-label, non-randomized comparison of venlafaxine and gabapentin as monotherapy or adjuvant therapy in the management of neuropathic pain in patients with peripheral neuropathy

William Eardley  1 , Cory Toth
Affiliations

An open-label, non-randomized comparison of venlafaxine and gabapentin as monotherapy or adjuvant therapy in the management of neuropathic pain in patients with peripheral neuropathy

William Eardley et al. J Pain Res. .

Abstract

Although many therapies are used in the management of neuropathic pain (NeP) due to polyneuropathy (PN), few comparison studies exist. We performed a prospective, non-randomized, unblended, efficacy comparison of the serotonin-norepinephrine reuptake inhibitor venlafaxine, as either monotherapy or adjuvant therapy, with a first-line medication for NeP, gabapentin, in patients with PN-related NeP. VAS pain scores were assessed after 3 and 6 months in intervention groups and in a cohort of patients receiving no pharmacotherapy. In a total of 223 patients, we analyzed pain quantity and quality (visual analogue scale [VAS] score, Brief Pain Inventory [BPI]), quality of life and health status measures [EuroQol 5 Domains, EQ-5D], Medical Outcomes Sleep Study Scale [MOSSS], Hospital Anxiety and Depression Scale [HADS] and Short Form 36 Health Survey [SF-36]) after 6 months of therapy. Significant improvements in VAS pain scores occurred for all treatment groups after 6 months. Improvements in aspects of daily life and anxiety were identified in all treatment groups. Our data suggest that monotherapy or adjuvant therapy with venlafaxine is comparable to gabapentin for NeP management. We advocate for head-to-head, randomized, double-blinded studies of current NeP therapies.

Keywords: gabapentin; neuropathic pain; peripheral neuropathy; pharmacotherapy; venlafaxine.

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Figures

Figure 1
Figure 1
Summary of patient flow throughout study. Abbreviations: NeP, neuropathic pain; PN, polyneuropathy.
Figure 2
Figure 2
Patient global impression of change (PGIC) was analyzed using a Cochran-Mantel-Haenszel procedure, adjusting for center in each case. Patients reported a significant perceived benefit with monotherapy compared to control group patients for each of venlafaxine (A) and gabapentin (B), as well as with adjuvant therapy for each of venlafaxine (C) and gabapentin (D). In contrast, the control group receiving no therapy had no significant change in PGIC reported (E).
See this image and copyright information in PMC

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