title: Efficacy of early treatment with carbamazepine in prevention of neuropathic pain in patients with spinal cord injury.
abstract: OBJECTIVE
  The aim of this study was to evaluate whether early treatment with carbamazepine decreases the incidence of neuropathic pain (NP) or its intensity in patients with spinal cord injury.
  
  
  METHODS
  This study was a randomized, double-blind, placebo-controlled clinical trial at a third-level university hospital involving patients older than 18 yrs with a diagnosis of spinal cord injury sustained within 2 wks before enrollment and without evidence of NP. The patients received either carbamazepine up to 600 mg/day or placebo for 1 mo. Pain intensity was measured with a 10-cm visual analog scale and the SF-36 bodily pain subscale; quality-of-life, with the Short Form 36 (SF-36) Scale; and depression, with the Zung Self-Rating Depression Scale. Measurements were carried out at the start of the randomized trial and at the 1-, 3-, and 6-month follow-up assessments.
  
  
  RESULTS
  Twenty-one of 46 patients developed NP. At the 1-, 3-, and 6-month follow-up assessments, NP was present in 4, 11, and 10 patients of the carbamazepine group and in 8, 9, and 8 patients of the placebo group, respectively. At 1 mo, two patients in the carbamazepine group vs. eight patients in the placebo group reported moderate/intense pain (visual analog scale, ≥4.0; P = 0.024). At the 3- and 6-month follow-up appointments, moderate/intense pain was reported by eight vs. six (P = 0.498) and six vs. eight patients (P = 0.298), carbamazepine and placebo group, respectively. There was no difference in the depression ratings or in any of the SF-36 scales.
  
  
  CONCLUSIONS
  Early intervention with carbamazepine decreased NP incidence at the 1-month but not at the 3- and 6-month follow-ups in the group of patients with acquired spinal cord injury.
authors.affiliation: Grupo Rehabilitación en Salud, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Fabio A
authors.initials: FA
authors.lastname: Salinas
authors.forename: Luz H
authors.initials: LH
authors.lastname: Lugo
authors.forename: Hector I
authors.initials: HI
authors.lastname: García
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D013119:Spinal Cord Injuries / Q000150:complications; D013997:Time Factors; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D002220:Carbamazepine