title: Efficacy of serotonin receptor blocker for symptomatic lumbar disc herniation.
abstract: Serotonin is one of the chemical mediators associated with nerve root inflammation and sciatic symptoms in lumbar disc herniation. The efficacy of serotonin 5-HT(2A) receptor blocker was examined in 44 patients with symptomatic lumbar disc herniation. A selective 5-HT(2A) receptor blocker (sarpogrelate hydroxychloride) was administered orally at a dose of 300 mg per day for 2 weeks. Visual analog scales of low back pain, sciatic pain, and numbness were significantly improved after the administration of the serotonin 5-HT(2A) receptor blocker. Clinical results were good (> 50% pain relief) in 23 patients, fair (25%-50% pain relief) in five patients, and poor (< 25% of pain relief) in 16 patients. Nineteen patients eventually required surgery because of muscle weakness or cauda equina symptoms. The effect of 5-HT(2A) blocker was good in 64% of patients who had uncontained disc herniation, whereas all patients with contained disc herniation had fair or poor results. Patients with uncontained disc herniation responded more favorably to the 5-HT(2A) blocker treatment than patients with contained disc herniation. A 5-HT(2A) blocker has the potential to block the cascade of acute nerve root inflammation and to alleviate symptoms in lumbar disc herniation.
authors.affiliation: Department of Orthopaedic Surgery, Hakodate Central General Hospital, Hokkaido, Japan. mkanayama@aol.com
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kanayama
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Keiichi
authors.initials: K
authors.lastname: Shigenobu
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamane
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000188:drug therapy / Q000209:etiology; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000188:drug therapy*; D017116:Low Back Pain / Q000188:drug therapy / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D010147:Pain Measurement; D012585:Sciatica / Q000188:drug therapy / Q000209:etiology; D012702:Serotonin Antagonists / Q000627:therapeutic use*; D013386:Succinates / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D012702:Serotonin Antagonists; D013386:Succinates; C064294:sarpogrelate