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Ziconotide infusion for severe chronic pain: case series of patients with neuropathic pain.
Pharmacotherapy. 2006 Mar; 26(3):395-402.P

Abstract

Ziconotide intrathecal infusion was recently approved by the United States Food and Drug Administration for the treatment of intractable severe chronic pain. Patients with neuropathic pain make up a significant population among those who experience chronic pain for which there are less than optimal pharmacotherapeutic options. Published clinical trials provide a global view of ziconotide efficacy and safety. A subset of patients in clinical trials obtained complete pain relief, a remarkable finding given the history of drug treatment for neuropathic pain. To provide more information regarding those who respond to ziconotide therapy, we discuss three patients with neuropathic pain who received ziconotide infusion. Two patients with longstanding neuropathic pain, one with complex regional pain syndrome (formerly known as reflex sympathetic dystrophy) of the leg and one with lumbar radiculitis, achieved temporary but complete pain relief from single 5- and 10-microg epidural test doses. In the third case, a patient with longstanding bilateral leg and foot neuropathic pain from acquired immunodeficiency syndrome and antiretroviral drug therapy achieved considerable pain relief from a long-term continuous intrathecal infusion. The patients who received a single dose had mild central nervous system adverse effects such as sedation, somnolence, nausea, headache, and lightheadedness. The patient who received the intrathecal infusion experienced mild-to-severe adverse effects depending on the rate of infusion; these effects included sedation, confusion, memory impairment, slurred speech, and double vision. This patient could sense impending adverse effects and made rate adjustments or suspended infusion to avert untoward symptoms. In all three cases, patients achieved considerable pain relief that was long-lasting and persisted well after dose administration or suspension of infusion.

Authors+Show Affiliations

Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky Medical Center, Lexington, Kentucky 40536, USA. dwermel@uky.eduNo affiliation info available

Pub Type(s)

Case Reports
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16503720

Citation

Wermeling, Daniel P., and Joseph R. Berger. "Ziconotide Infusion for Severe Chronic Pain: Case Series of Patients With Neuropathic Pain." Pharmacotherapy, vol. 26, no. 3, 2006, pp. 395-402.
Wermeling DP, Berger JR. Ziconotide infusion for severe chronic pain: case series of patients with neuropathic pain. Pharmacotherapy. 2006;26(3):395-402.
Wermeling, D. P., & Berger, J. R. (2006). Ziconotide infusion for severe chronic pain: case series of patients with neuropathic pain. Pharmacotherapy, 26(3), 395-402.
Wermeling DP, Berger JR. Ziconotide Infusion for Severe Chronic Pain: Case Series of Patients With Neuropathic Pain. Pharmacotherapy. 2006;26(3):395-402. PubMed PMID: 16503720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ziconotide infusion for severe chronic pain: case series of patients with neuropathic pain. AU - Wermeling,Daniel P, AU - Berger,Joseph R, PY - 2006/3/1/pubmed PY - 2006/9/2/medline PY - 2006/3/1/entrez SP - 395 EP - 402 JF - Pharmacotherapy JO - Pharmacotherapy VL - 26 IS - 3 N2 - Ziconotide intrathecal infusion was recently approved by the United States Food and Drug Administration for the treatment of intractable severe chronic pain. Patients with neuropathic pain make up a significant population among those who experience chronic pain for which there are less than optimal pharmacotherapeutic options. Published clinical trials provide a global view of ziconotide efficacy and safety. A subset of patients in clinical trials obtained complete pain relief, a remarkable finding given the history of drug treatment for neuropathic pain. To provide more information regarding those who respond to ziconotide therapy, we discuss three patients with neuropathic pain who received ziconotide infusion. Two patients with longstanding neuropathic pain, one with complex regional pain syndrome (formerly known as reflex sympathetic dystrophy) of the leg and one with lumbar radiculitis, achieved temporary but complete pain relief from single 5- and 10-microg epidural test doses. In the third case, a patient with longstanding bilateral leg and foot neuropathic pain from acquired immunodeficiency syndrome and antiretroviral drug therapy achieved considerable pain relief from a long-term continuous intrathecal infusion. The patients who received a single dose had mild central nervous system adverse effects such as sedation, somnolence, nausea, headache, and lightheadedness. The patient who received the intrathecal infusion experienced mild-to-severe adverse effects depending on the rate of infusion; these effects included sedation, confusion, memory impairment, slurred speech, and double vision. This patient could sense impending adverse effects and made rate adjustments or suspended infusion to avert untoward symptoms. In all three cases, patients achieved considerable pain relief that was long-lasting and persisted well after dose administration or suspension of infusion. SN - 0277-0008 UR - https://www.unboundmedicine.com/medline/citation/16503720/Ziconotide_infusion_for_severe_chronic_pain:_case_series_of_patients_with_neuropathic_pain_ DB - PRIME DP - Unbound Medicine ER -