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CNS Update: Efficacy and safety of different antidepressants and anticonvulsants in CPSP

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eMediNexus    25 January 2023

A recent study evaluated the efficacy and safety of antidepressants and anticonvulsants in treating central poststroke pain (CPSP) by network meta-analysis and provided an evidence-based foundation for clinical practice.

 

It searched PubMed, Cochrane Library, EMBASE, CNKI, APA PsycINFO, Wanfang, VIP, and other databases to find clinical randomized controlled studies (RCTs) on drug treatment of CPSP. 

The study included 13 RCTs, 1040 patients, and nine drugs. It found the effectiveness ranking as rated by the visual analog scale (VAS) as gabapentin > pregabalin > fluoxetine > lamotrigine > duloxetine > serqulin > amitriptyline > carbamazepine > vitamin B. 

Ranking by the numerical rating scale (NRS) was pregabalin > gabapentin > carbamazepine. 

Hamilton depression scale (HAMD) showed ranking as pregabalin> duloxetine > gabapentin > amitriptyline.

 

This study shows the effectiveness of all nine drugs in relieving the pain of CPSP patients to different degrees. Among all the drugs tested, pregabalin and gabapentin showed the most significant effect, and gabapentin and pregabalin also had the most adverse reactions. More multicenter, large sample, double-blind clinical randomized controlled trials are needed to back the results of this study.

 

Chen KY, Li RY. Efficacy and safety of different antidepressants and anticonvulsants in central poststroke pain: A network meta-analysis and systematic review. PLoS ONE. 2022;17(10): e0276012. https://doi.org/10.1371/journal.pone.0276012

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