A randomized study of the effect of oral lamotrigine and hydromorphone on pain and hyperalgesia following heat/capsaicin sensitization.
In this randomized double-blind placebo-controlled study, the analgesic effect of oral lamotrigine (400 mg) on cutaneous sensitization induced with the heat/capsaicin sensitization model was compared with the effect of oral hydromorphone (8 mg) in healthy volunteers. In a separate session, intravenous remifentanil (0.10 microg.kg(-1).min(-1)) and placebo were administered. This session was used as an additional reference comparator. Outcome measures were the areas of secondary hyperalgesia to brush and von Frey hair stimulation and the painfulness of noxious thermal stimulation in nonsensitized skin. Compared with placebo, both intravenous remifentanil and oral hydromorphone significantly suppressed secondary hyperalgesia and acute thermal nociception. Oral lamotrigine did not reduce secondary hyperalgesia or acute thermal nociception but produced side effects of severity comparable with that of oral hydromorphone. Although lamotrigine is efficacious in the management of some types of chronic neuropathic pain, the lack of effect of this agent on human experimental pain suggests that its analgesic effects depend on nerve injury-associated abnormalities, which cannot be simulated in healthy human volunteers.
Petersen
Karin L
KL
Pain Clinical Research Center and Department of Neurology, University of California, San Francisco, CA 94115, USA. klp@itsa.ucsf.edu
Maloney
Alan
A
Hoke
Frank
F
Dahl
Jørgen B
JB
Rowbotham
Michael C
MC
D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology*; D000927:Anticonvulsants / Q000494:pharmacology*; D002211:Capsaicin / Q000494:pharmacology*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D006358:Hot Temperature; D006801:Humans; D004091:Hydromorphone / Q000494:pharmacology*; D006930:Hyperalgesia / Q000139:chemically induced* / Q000188:drug therapy*; D000077213:Lamotrigine; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement / Q000187:drug effects; D010880:Piperidines / Q000494:pharmacology; D000077208:Remifentanil; D014227:Triazines / Q000494:pharmacology*
D000701:Analgesics, Opioid; D000927:Anticonvulsants; D018691:Excitatory Amino Acid Antagonists; D010880:Piperidines; D014227:Triazines; D000077208:Remifentanil; D004091:Hydromorphone; D002211:Capsaicin; D000077213:Lamotrigine