title: Capsaicin 8% Patch for Central and Peripheral Neuropathic Pain of Persons with Incomplete Spinal Cord Injury: Two Case Reports.
abstract: Neuropathic pain after spinal cord injury is common and often refractory to standard treatments. The capsaicin 8% patch is a Food and Drug Administration-approved treatment of neuropathic pain in postherpetic neuralgia and has demonstrated significant efficacy in human immunodeficiency virus-autonomic neuropathy. The patch defunctionalizes transient receptor potential vanilloid 1 receptors, impairing cutaneous nociceptors for a prolonged period (i.e., 8-12 wks) with no systemic side effects. A retrospective review was conducted on the effects of the patch in two patients with spinal cord injury and neuropathic pain refractory to standard treatments. Two weeks after application, both patients reported complete pain relief. Average onset of relief of 4 days and average duration of relief of 197 days, requiring only one to four applications per year, paralleled findings reported in postherpetic neuralgia and human immunodeficiency virus-autonomic neuropathy trials. Upregulation of capsaicin-sensitive transient receptor potential vanilloid 1 receptors after spinal cord injury has been reported. The capsaicin 8% patch is a promising therapeutic agent for neuropathic pain in spinal cord injury.
authors.affiliation: From the Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, Texas (MT, HY); and Spinal Cord Injury Service, Audie L. Murphy Veteran's Administration Hospital, San Antonio, Texas (MT).
authors.forename: Michelle
authors.initials: M
authors.lastname: Trbovich
authors.forename: Huiqing
authors.initials: H
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D002211:Capsaicin / Q000008:administration & dosage*; D006801:Humans; D006930:Hyperalgesia / Q000188:drug therapy / Q000209:etiology; D008297:Male; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D018689:Sensory System Agents / Q000008:administration & dosage*; D013119:Spinal Cord Injuries / Q000150:complications*; D057968:Transdermal Patch
chemical_list: D018689:Sensory System Agents; D002211:Capsaicin