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Levetiracetam in patients with central neuropathic post-stroke pain - a randomized, double-blind, placebo-controlled trial.

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Title: Levetiracetam in patients with central neuropathic post-stroke pain - a randomized, double-blind, placebo-controlled trial.
Authors: Jungehulsing, G. J., Israel, H., Safar, N., Taskin, B., Nolte, C. H., Brunecker, P., Wernecke, K.‐D., Villringer, A.
Source: European Journal of Neurology. Feb2013, Vol. 20 Issue 2, p331-337. 7p. 1 Diagram, 2 Charts, 2 Graphs.
Subjects: Neuropathy, Pain management, Stroke, Allodynia, Quality of life
Abstract: Background and purpose Central post-stroke pain ( CPSP) is a severe chronic neuropathic pain condition defined as a spontaneous pain or allodynia corresponding to a vascular lesion. It usually evolves weeks after stroke, and can distinctively impair the quality of life. Treatment is complex and mostly unsatisfactory. We hypothesized that the anti-epileptic drug levetiracetam ( LEV) improves CPSP compared with placebo. The purpose of this study was to examine the efficacy and tolerability of LEV in patients with CPSP. Methods In a double-blind, placebo-controlled, crossover study design patients with CPSP lasting at least 3 months and a pain score ≥ 4 on the 11-point Likert scale were treated over two 8-week periods with a maximum dose up to 3000 mg LEV or placebo. Primary endpoint was a median pain lowering ≥ 2 in the final treatment week compared with the last baseline week. Secondary outcome measures comprised additional pain ratings, depression, sleep quality, quality of life and patients' global impression of change. Results Of 42 patients, 33 [61.5 years (40-76); 38% women] completed the study. Side effects and withdrawals were more frequent in the LEV ( n = 5) group than in the placebo group ( n = 1). Patients treated with LEV did not show any improvement of pain or changes in secondary outcome parameters compared with placebo. Conclusions LEV is not effective in treatment for CPSP. The mode of action of LEV does not exert an analgesic effect in chronic CPSP. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Levetiracetam in patients with central neuropathic post-stroke pain - a randomized, double-blind, placebo-controlled trial.
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Feb2013, Vol. 20 Issue 2, p331-337. 7p. 1 Diagram, 2 Charts, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Neuropathy%22">Neuropathy</searchLink><br /><searchLink fieldCode="DE" term="%22Pain+management%22">Pain management</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke%22">Stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Allodynia%22">Allodynia</searchLink><br /><searchLink fieldCode="DE" term="%22Quality+of+life%22">Quality of life</searchLink>
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  Data: Background and purpose Central post-stroke pain ( CPSP) is a severe chronic neuropathic pain condition defined as a spontaneous pain or allodynia corresponding to a vascular lesion. It usually evolves weeks after stroke, and can distinctively impair the quality of life. Treatment is complex and mostly unsatisfactory. We hypothesized that the anti-epileptic drug levetiracetam ( LEV) improves CPSP compared with placebo. The purpose of this study was to examine the efficacy and tolerability of LEV in patients with CPSP. Methods In a double-blind, placebo-controlled, crossover study design patients with CPSP lasting at least 3 months and a pain score ≥ 4 on the 11-point Likert scale were treated over two 8-week periods with a maximum dose up to 3000 mg LEV or placebo. Primary endpoint was a median pain lowering ≥ 2 in the final treatment week compared with the last baseline week. Secondary outcome measures comprised additional pain ratings, depression, sleep quality, quality of life and patients' global impression of change. Results Of 42 patients, 33 [61.5 years (40-76); 38% women] completed the study. Side effects and withdrawals were more frequent in the LEV ( n = 5) group than in the placebo group ( n = 1). Patients treated with LEV did not show any improvement of pain or changes in secondary outcome parameters compared with placebo. Conclusions LEV is not effective in treatment for CPSP. The mode of action of LEV does not exert an analgesic effect in chronic CPSP. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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