Undergraduate Medical Education, Capital Medical University, Beijing, People's Republic of China.
Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Pain Physician. 2024 May;27(4):263-272.
Flupentixol and melitracen are being investigated for their potential effectiveness in managing persistent idiopathic facial pain (PIFP), based on their mechanisms of action as dopamine receptor antagonists and noradrenaline/serotonin reuptake inhibitors, respectively. The efficacy and safety of flupentixol and melitracen (FM) tablets in treating PIFP were retrospectively analyzed at our hospital.
The aim of this study is to determine the effectiveness and safety of FM tablets in treating PIFP.
Retrospective unicentric cohort design.
An academic university hospital.
A retrospective analysis was conducted on a cohort comprising 128 patients with a definite diagnoses of PIFP who were treated with FM tablets (flupentixol 0.5 mg and melitracen 10 mg tablet, >= 4 tablets/d) from January 2022 through May 2023 at an academic university hospital. Baseline conditions were statistically described, and Numeric Rating Scale (NRS-11) scores of pain levels before and during treatment were collected. Pain relief rates were calculated. Differences in baseline characteristics between responsive and unresponsive patients were evaluated using statistical tests. Additionally, the side effects experienced during treatment were summarized.
Among the included 128 patients, 105 (82.0%) patients achieved pain relief (pain NRS-11 score reduction rate >= 50%). The median treatment onset time was 3 (1-7) days. NRS-11 scores of responsive patients at week 2, week 4, week 8, and week 12 were significantly lower than the baseline NRS-11 scores (P < 0.001), regardless of their Hamilton Depression Rating Scale score. Pain duration was the only factor that related to responsiveness (Wilcoxon rank sum test, P < 0.001; logistic regression, P = 0.001). No serious side effects that could affect patients' lives were observed during the first week of treatments.
Due to its retrospective nature, this study is limited by its lack of a randomized control. The lack of data on nonresponders who did not achieve significant pain relief hinders assessing overall change and the placebo effects'. Patients previously treated with antidepressants were excluded, making it hard to determine if FM tablets were a better treatment for PIFP. Additionally, the small sample size in a single center may be influenced by chance variation in pain relief.
FM tablets showed its potential in the management of PIFP with considerable efficacy and safety. Early administration of FM tablets after a PIFP diagnosis may result in a high possibility of pain relief.
氟哌噻吨美利曲辛用于治疗持续性特发性面神经痛（PIFP），是基于其作为多巴胺受体拮抗剂和去甲肾上腺素/ 5-羟色胺再摄取抑制剂的作用机制。本研究回顾性分析我院氟哌噻吨美利曲辛（FM）片治疗 PIFP 的疗效和安全性。
本研究旨在评估 FM 片治疗 PIFP 的有效性和安全性。
回顾性单中心队列设计。
一所学术型大学医院。
回顾性分析 2022 年 1 月至 2023 年 5 月在我院接受 FM 片（氟哌噻吨 0.5mg，美利曲辛 10mg 片剂，>=4 片/天）治疗的 128 例明确诊断为 PIFP 的患者队列。统计描述基线情况，并收集治疗前后疼痛水平的数字评分量表（NRS-11）评分。计算疼痛缓解率。使用统计检验评估反应性和无反应性患者之间的基线特征差异。此外，总结治疗期间的不良反应。
纳入的 128 例患者中，105 例（82.0%）患者疼痛缓解（疼痛 NRS-11 评分降低率>=50%）。中位治疗起始时间为 3（1-7）天。第 2、4、8 和 12 周时，反应性患者的 NRS-11 评分显著低于基线 NRS-11 评分（P<0.001），与汉密尔顿抑郁量表评分无关。疼痛持续时间是唯一与反应性相关的因素（Wilcoxon 秩和检验，P<0.001；logistic 回归，P=0.001）。在治疗的第一周内，未观察到严重影响患者生活的不良反应。
由于其回顾性，本研究受到缺乏随机对照的限制。未获得未获得显著疼痛缓解的无反应者的数据，这使得评估总体变化和安慰剂效应变得困难。排除了先前接受过抗抑郁治疗的患者，因此无法确定 FM 片是否是治疗 PIFP 的更好选择。此外，单中心的小样本量可能受到疼痛缓解的随机变化影响。
FM 片在治疗 PIFP 方面显示出良好的疗效和安全性。在 PIFP 诊断后早期使用 FM 片可能会提高疼痛缓解的可能性。
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