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Non-opioid pharmacologic treatment of chronic spinal cord injury-related pain
The Journal of Spinal Cord Medicine ( IF 1.8 ) Pub Date : 2020-03-17 , DOI: 10.1080/10790268.2020.1730109
Mendel Kupfer 1 , Christopher S Formal 1
Affiliation  

Purpose: Spinal cord injury-related pain is often a severe debilitating condition that adversely affects the patient’s physical health, psychological wellbeing and quality of life. Opioid medications have historically been prescribed to this population with great frequency. As opioid abuse disorder becomes an ever-worsening public health issue, more attention must be placed upon non-opioid options. This paper reviews non-opioid medications to be considered when treating spinal cord injury-related pain. The pertinent literature is reviewed, and the advantages and pitfalls of various medication options are discussed in the complicated context of the individual with a spinal cord injury.

Methods: Peer-reviewed journal articles and medication package insert data are reviewed.

Results:. The non-opioid medications with the greatest evidence for efficacy in the treatment of chronic spinal cord injury-related pain are drawn from the antiepileptic drug and antidepressant categories though the specific selection must be nuanced to the particular individual patient. More research is required to understand the role of calcitonin, lithium, and marijuana in treating spinal cord injury-related pain.

Conclusions: The complex clinical situation of each individual patient must be weighed against the risks and benefits of each medication, as reviewed in this paper, to determine the ideal treatment strategy for chronic spinal cord injury-related pain.



中文翻译:

慢性脊髓损伤相关疼痛的非阿片类药物治疗

目的:脊髓损伤相关疼痛通常是一种严重的使人衰弱的疾病,会对患者的身体健康、心理健康和生活质量产生不利影响。历史上,阿片类药物被频繁地开给这一人群。随着阿片类药物滥用障碍成为一个日益严重的公共卫生问题,必须更多地关注非阿片类药物的选择。本文回顾了治疗脊髓损伤相关疼痛时应考虑的非阿片类药物。回顾了相关文献,并在脊髓损伤个体的复杂背景下讨论了各种药物选择的优缺点。

方法:审查同行评审的期刊文章和药物包装插页数据。

结果:。在治疗慢性脊髓损伤相关疼痛方面具有最大疗效证据的非阿片类药物来自抗癫痫药和抗抑郁药类别,但具体选择必须针对特定个体患者进行细微差别。需要更多的研究来了解降钙素、锂和大麻在治疗脊髓损伤相关疼痛中的作用。

结论:如本文所述,必须权衡每位患者的复杂临床情况与每种药物的风险和益处,以确定慢性脊髓损伤相关疼痛的理想治疗策略。

更新日期:2020-03-17
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