ProHealth me-cfs 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

|
|
 
Print Page
Email Article

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

  [ 2 votes ]   [ Post a Comment ]
www.ProHealth.com • October 9, 2013

previous article next article

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.



previous article
  Rating 3 (2 votes) next article




DISCUSS THIS ARTICLE   (0 existing comments) 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

Save on Your Next Order

Featured Products
Fatigued to Fantastic!™ Energy Revitalization System - Berry Splash Fatigued to Fantastic!™ Energy Revitalization System - Berry Splash
Vitality, Health and Lasting Energy
B-12 Extreme™ B-12 Extreme™
The Most Potent Vitamin B-12 on Earth
Ubiquinol CoQ-10 Ubiquinol CoQ-10
Reduced, Active Form of CoQ10
Phosphatidyl Serine Phosphatidyl Serine
Sharpen memory and mental acuity
Ubiquinol CoQ-10 Ubiquinol CoQ-10
Reduced, Active Form of CoQ10

Most Viewed Articles
What's the Hidden Cause Behind YOUR Fibromyalgia Flares? [more]

Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be ... [more]

Massage Therapy Studies for Fibromyalgia Reviewed [more]

How to Limit or Minimize Your Fibromyalgia Flare [more]

Mitochondrial Dysfunction, Post-Exertional Malaise and CFS/ME [more]

The Devil Is In The Details – A Herpes Simplex Virus Inquiry For Fibromyalgia and Chronic Fatigue Sy... [more]

Sympathetic Nervous System Dysfunction in FIbromyalgia and Overlapping Conditions [more]

Review of Nutritional Supplements Used for ME/CFS and FM [more]

VIDEO: Mom Needs to Lie Down [more]

FREE: Spring Volume of Broken Body, Wounded Spirit – March 22, 2014 [more]


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