ProHealth fibromyalgia Vitamin and Natural Supplement Store and Health
Log In  |  My Account  |  View Cart  View Your ProHealth Vitamin and Supplement Shopping Cart
800-366-6056  |  Contact Us  |  Help

|
|
|

Trending News

10 "Healthy" Foods That Are NOT Fibro-Friendly

VIDEO: What It Feels Like To Live With Fibro

Fibromyalgia “Is All in Your Head” and Other Abusive Nonsense

Fibromyalgia Research Update from Integrated Tissue Dynamics

VIDEO: Treating Fibromyalgia with Oxytocin

SURVEY: Patient Experience with Physicians

The Brain Boosting and Fatigue Fighting B-12

Fibromyalgia, Family and Friends: 8 Ways to Improve Relationships

Melatonin Regulates Inflammation Resolution in Fibromyalgia and Other Disorders

Fibromyalgia and Disability Claims

 
Print Page
Email Article

Analgesic Effect of Savella (milnacipran) on Spinal Pain Pathway for Fibromyalgia Patients

  [ 2 votes ]   [ Discuss This Article ]
www.ProHealth.com • October 9, 2013


Note: You may download the full text of this article free HERE.

Dual reuptake inhibitor milnacipran and spinal pain pathways in fibromyalgia patients: a randomized, double-blind, placebo-controlled trial.

By Alain Matthey, MD, et al.

Abstract:

BACKGROUND: Investigations based on quantitative sensory testing have consistently shown evidence of allodynia in fibromyalgia syndrome (FMS) patients involving both the spinal and supraspinal pain regulatory systems. Functional imaging studies have demonstrated enhanced neural activities in pain-related brain areas as well as impairment of pain inhibition in the descending nociceptive regulatory system. A higher state of excitability of spinal nociceptive neurons as evidenced by lowered nociceptive flexion reflex R-III (NFR) threshold was reported for FMS patients. The NFR procedure has been shown to be a valuable tool to evaluate pharmacologically active therapeutic agents at the spinal level.

OBJECTIVE: Serotonin-noradrenaline reuptake inhibitors have been shown to reduce pain in FMS patients possibly through descending monoaminergic pain pathways modulation. This randomized double-blind placebo-controlled trial assessed the pharmacodynamic activity of the dual-reuptake inhibitor milnacipran (MLN) at the spinal level by means of the objective spinal NFR.

STUDY DESIGN: Randomized, double-blind, placebo-controlled trial

SETTING: A single academic medical center, outpatient setting

METHODS: Seven-week exposure (100, 150, 200mg/day) in women fibromyalgia patients. Evaluation consisted of extensive quantitative sensory testing including determination of the NFR threshold, self-reported standard questionnaires investigating pain, visual analog scales, fibromyalgia impact, health-related quality of life, depression and anxiety questionnaires, as well as the Patient's Global Impression of Change (PGIC). Analysis of covariance adjusted for baseline value was used for all endpoints.

RESULTS: Seventy-seven (39 placebo, 38 milnacipran all doses) out of 80 randomized patients were available for analysis.

  • The absence of influence of MLN (any dose) on the NFR surprisingly contrasted with the dose-dependent analgesic effect observed in MLN-treated patients with an adjusted change difference of -18.4mm (-30.9; -5.8) in pain reduction between placebo and the maximum dosage (200 mg) MLN groups (P = 0.02).

  • Unchanged depression and anxiety scores confirmed the predominant selectivity of the analgesic effect of MLN on nociceptive pain pathway.

  • Self-reported questionnaires consistently reflected the positive effects of MLN on quality of life and psychological well-being.

  • Odds ratio 5.1 for PGIC responders (i.e. much/very much improved) was significantly in favor of MLN (P = 0.04).

CONCLUSION: Milnacipran has a predominantly supraspinal analgesic effect as evidenced by the significant clinical benefits and the absence of changes in the nociceptive spinal reflex threshold. Higher dose was associated with higher pain reduction. Reported analgesia was independent of patients' emotional status.

Source: Pain Physician, September – October 2013. By Alain Matthey, MD, Christine Cedraschi, PhD, Valerie Piguet, MD, Marie Besson, MD, Jocelyne Chabert, PhD, Youssef Daali, PhD, Delphine Courvoisier, PhD, Agnes Montagne, MD, Pierre Dayer, MD, and Jules A Desmeules, MD. Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Switzerland;Division of General Medical Rehabilitation, Geneva University Hospitals, Switzerland; University of Geneva, Switzerland; Division of Cl.





Discuss This Article Post a Comment 




[ Be the first to comment on this article ]




 
Free Chronic Fatigue Syndrome and Fibromyalgia Newsletters
Subscribe to
Our FREE
Newsletter
Subscribe Now!
Receive up-to-date ME/CFS & Fibromyalgia treatment and research news
 Privacy Guaranteed  |  View Archives

Featured Products

FibroSleep™ by ProHealth FibroSleep™ by ProHealth
The All-in-One Natural Sleep Aid
Hydroxocobalamin Extreme™ Hydroxocobalamin Extreme™
The B-12 your brain needs for detox & sharpness
Fibro Freedom™ Fibro Freedom™
Soothes, strengthens & revitalizes
B-12 Extreme™ B-12 Extreme™
The Most Potent Vitamin B-12 on Earth
Optimized Curcumin Longvida® by ProHealth Optimized Curcumin Longvida® by ProHealth
Supports Cognition, Memory & Overall Health

Natural Remedies

Red: The Color of Energy, Health, and B-12 Red: The Color of Energy, Health, and B-12
Running on Empty? Fuel Up with NADH Running on Empty? Fuel Up with NADH
Live Longer: Groundbreaking Research on Omega-3s Live Longer: Groundbreaking Research on Omega-3s
Front Line Defense Against Colds & Flu - Support for Healthy Immune System Balance Front Line Defense Against Colds & Flu - Support for Healthy Immune System Balance
More Weight Loss than Any Other Discovery in Supplement History More Weight Loss than Any Other Discovery in Supplement History

FIBROMYALGIA RESOURCES
What is Fibromyalgia?
Fibromyalgia 101
Fibromyalgia Symptoms
Fibromyalgia Treatments
| CFS RESOURCES
What is CFS?
ME/CFS 101
ME/CFS Symptoms
ME/CFS Treatments
| FORUMS
Fibromyalgia
ME/CFS
ADVANCED MEDICAL LABS
WHOLESALE  |  AFFILIATES
GUARANTEE
CONTACT US
PRIVACY
RSS
SITE MAP
ProHealth on Facebook  ProHealth on Twitter  ProHealth on Pinterest  ProHealth on Google Plus
Credit Card Processing