Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Indian J Pharmacol. 2011 Sep;43(5):596-8. doi: 10.4103/0253-7613.84980.
Neuropathic pain in cancer patients remain a treatment challenge. Many of the anticancer drugs have to be abandoned because patients develop neuropathic pain. Several antiepileptic drugs like carbamazepine, phenytoin, lamotrigine, felbamate are effective in neuropathic pain and trigeminal neuralgia. However, their efficacy varies.
The aim of this study is to compare the efficacy of antiepileptic drugs in neuropathic pain induced by anticancer drugs.
Neuropathic pain was induced in rats by injecting 4 doses of paclitaxel. The rats were divided into four groups of six animals each. Group I was treated with oral carbamazepine (cbz) 100 mg/kg, group II received oral gabapentin (gbp) 60 mg/kg, and group III was treated with oral lamotrigine (lam) 40 mg/kg and group IV was the control group. Behavioural testing for thermal hyperalgesia and mechanical hyperalgesia was assessed from 26(th) day of paclitaxel administration to next five days by hot plate method and Randall Siletto test, respectively, in all the four groups. One way analysis of variance followed by Scheffe's post hoc test was used for statistical analysis.
In thermal hyperalgesia lam treated group was found to be significantly (P < 0.001) superior to cbz and gbp treated group. In mechanical hyperalgesia, lam group showed significant response (P < 0.05) as compared to gbp group. However, the gbp treated group showed a significant (P < 0.01) improvement after three days of treatment.
In paclitaxel induced neuropathic pain, lamotrigine appears to be a promising drug. The difference in responses shown by different antiepileptics' depends on the etiology of the underlying mechanisms in neuropathic pain.
癌症患者的神经性疼痛仍然是治疗的挑战。许多抗癌药物因患者出现神经性疼痛而不得不被放弃。几种抗癫痫药物如卡马西平、苯妥英钠、拉莫三嗪、非氨酯在神经性疼痛和三叉神经痛中有效。然而，它们的疗效不同。
本研究旨在比较抗癫痫药物治疗抗癌药物引起的神经性疼痛的疗效。
通过注射 4 剂紫杉醇在大鼠中诱导神经性疼痛。大鼠被分为四组，每组 6 只。第 I 组给予口服卡马西平（cbz）100mg/kg，第 II 组给予口服加巴喷丁（gbp）60mg/kg，第 III 组给予口服拉莫三嗪（lam）40mg/kg，第 IV 组为对照组。从紫杉醇给药的第 26 天开始，通过热板法和 Randall Siletto 试验分别在所有四组中评估热痛觉过敏和机械性痛觉过敏的行为测试，持续 5 天。采用单因素方差分析，然后进行 Scheffe 事后检验进行统计学分析。
在热痛觉过敏中，发现 lam 治疗组明显优于 cbz 和 gbp 治疗组（P < 0.001）。在机械性痛觉过敏中，lam 组与 gbp 组相比显示出显著的反应（P < 0.05）。然而，gbp 治疗组在治疗 3 天后显示出显著的改善（P < 0.01）。
在紫杉醇诱导的神经性疼痛中，拉莫三嗪似乎是一种有前途的药物。不同抗癫痫药物的反应差异取决于神经性疼痛潜在机制的病因。
