USO DE GABAPENTINA PARA O TRATAMENTO DA DOR NEUROPÁTICA
REVISÃO DA LITERATURA
Keywords:
Gabapentine for neuropathic pain, neuropathic pain, gabapentine, post herpetic pain,Abstract
Justificativa e objetivo: Dor neuropática é uma síndrome complexa que afeta o sistema somatossensorial. Classificada como crônica e de difícil tratamento, apresenta importante impacto familiar, laboral e social. O objetivo deste estudo foi pesquisar a efetividade da gabapentina no controle da dor neuropática por meio de uma revisão da literatura. Conteúdo: Artigos revisados demonstraram que a gabapentina, isoladamente ou associada a outros fármacos, é efetiva no tratamento da dor neuropática nas seguintes situações: dor neuropática localizada, pós-herpética, associada à SIDA, pós-tumoral, dor ciática crônica, neuralgia do trigêmio, doença de Fabry, hiperalgesia por capsaisina, dor neuropática radicular (tratamento tópico) e lesão medular aguda, com exceção de três artigos que abordaram o uso da gabapentina para dor lombar baixa, dor neuropática em paciente com SIDA e dor pós-herpética. Na Europa estima-se que 20% da população possui dor crônica, sendo que 6 a 8% apresentam dor neuropática. O tratamento objetiva aumentar o limiar da nocicepção melhorando a qualidade de vida. A efetividade da gabapentina está relacionada à indicação e ao uso clínico adequados, demonstrando benefício no tratamento dos quadros agudos de dor neuropática, tanto com altas doses, como em administrações repetidas.Associada a outros fármacos e a medidas gerais cognitivas, comportamentais e físicas, parece ser mais efetiva. Conclusões: A dor neuropática é responsável por um grande número de consultas e afastamentos do trabalho. A revisão demonstrou que a gabapentina é uma opção para o tratamento da dor neuropática, apresentando poucos efeitos indesejáveis.
References
REFERÊNCIAS BIBLIOGRÁFICAS
Kilic FS, Sirmagul B, Yildirim E, Oner S, Erol K. Antinociceptive effects of gabapentin & its mechanism of action in experimental animal studies. Indian J Med Res. 2012;135(5):630-635. http://www.ncbi.nlm.nih.gov/pubmed/22771591. Accessed March 5, 2017.
De Felice M, Ossipov MH. Cortical and subcortical modulation of pain. Pain Manag. 2016;6(2):111-120. doi:10.2217/pmt.15.63.
Holm B, Bandholm T, Lunn TH, et al. Role of preoperative pain, muscle function, and activity level in discharge readiness after fast-track hip and knee arthroplasty. Acta Orthop. 2014;85(5):488-492. doi:10.3109/17453674.2014.934186.
Kraychete DC, Gozzani JL, Kraychete AC. Dor neuropática: aspectos neuroquímicos. Rev Bras Anestesiol. 2008;58(5):492-505. doi:10.1590/S0034-70942008000500008.
Xu L, Zhang Y, Huang Y. Advances in the Treatment of Neuropathic Pain. In: Advances in Experimental Medicine and Biology. Vol 904. ; 2016:117-129. doi:10.1007/978-94-017-7537-3_9.
Kukkar A, Bali A, Singh N, Jaggi AS. Implications and mechanism of action of gabapentin in neuropathic pain. Arch Pharm Res. 2013;36(3):237-251. doi:http://dx.doi.org/10.1007/s12272-013-0057-y.
Wiffen PJ, Derry S, Moore RA, et al. Antiepileptic drugs for neuropathic pain and fibromyalgia - an overview of Cochrane reviews. Cochrane database Syst Rev. 2013;(11):CD010567. doi:10.1002/14651858.CD010567.pub2.
Kremer M, Salvat E, Muller A, Yalcin I, Barrot M. Antidepressants and gabapentinoids in neuropathic pain: Mechanistic insights. Neuroscience. July 2016. doi:10.1016/j.neuroscience.2016.06.057.
Farquhar-Smith WP. Anatomy, physiology and pharmacology of pain. Anaesth Intensive Care Med. 2008;9(1):3-7. doi:10.1016/j.mpaic.2007.10.011.
Gadient PM, Smith JH. The neuralgias: Diagnosis and management. Curr Neurol Neurosci Rep. 2014;14(7). doi:10.1007/s11910-014-0459-3.
Alles SRA, Smith PA. The Anti-Allodynic Gabapentinoids: Myths, Paradoxes, and Acute Effects. Neuroscientist. 2016. doi:10.1177/1073858416628793.
Borschitz T, Schlicht S, Siegel E, Hanke E, von Stebut E. Improvement of a Clinical Score for Necrotizing Fasciitis: “Pain Out of Proportion” and High CRP Levels Aid the Diagnosis. PLoS One. 2015;10(7):e0132775. doi:10.1371/journal.pone.0132775.
Brodin E, Ernberg M, Olgart L, Olgart SL. Neurobiology: General considerations – from acute to chronic pain Pain – a significant part of life – still an elusive figure. Nor Tann Tid. 2016;126:28-33.
Calandre EP, Rico-Villademoros F, Slim M. Alpha 2 delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use. Expert Rev Neurother. 2016;16(11):1263-1277. doi:10.1080/14737175.2016.1202764.
Gierthmühlen J, Baron R. Neuropathic Pain. Semin Neurol. 2016;36(5):462-468. doi:10.1055/s-0036-1584950.
Alles SRA, Smith PA. The Anti-Allodynic Gabapentinoids: Myths, Paradoxes, and Acute Effects. Neurosci. 2017;23(1):40-55. doi:10.1177/1073858416628793.
Hamm C, Gary R, McIntyre IM. Gabapentin concentrations and postmortem distribution. Forensic Sci Int. 2016;262:201-203. doi:10.1016/j.forsciint.2016.03.028.
Salah S, Thomas L, Ram S, Clark G, Enciso R. Systematic Review and Meta-analysis of the Efficacy of Oral Medications Compared with Placebo Treatment in the Management of Postherpetic Neuralgia. J Oral Facial Pain Headache. 2016;30(3):255-266. doi:10.11607/ofph.1629.
Mallick-Searle T, Snodgrass B, Brant JM. Postherpetic neuralgia: epidemiology, pathophysiology, and pain management pharmacology. J Multidiscip Healthc. 2016;9:447-454. doi:10.2147/JMDH.S106340.
Wang J, Zhu Y. Different doses of gabapentin formulations for postherpetic neuralgia: A systematical review and meta-analysis of randomized controlled trials. J Dermatolog Treat. 2017;28(1):65-77. doi:10.3109/09546634.2016.1163315.
Schmader K. Herpes Zoster. Clin Geriatr Med. 2016;32(3):539-553. doi:10.1016/j.cger.2016.02.011.
Mehta N, Bucior I, Bujanover S, Shah R, Gulati A. Relationship between pain relief, reduction in pain-associated sleep interference, and overall impression of improvement in patients with postherpetic neuralgia treated with extended-release gabapentin. Health Qual Life Outcomes. 2016;14:54. doi:10.1186/s12955-016-0456-0.
Patient- and Family-Centered Care Initiatives in Acute Care Settings: A Review of the Clinical Evidence, Safety and Guidelines. Canadian Agency for Drugs and Technologies in Health; 2015.
Hadley GR, Gayle JA, Ripoll J, et al. Post-herpetic Neuralgia: a Review. Curr Pain Headache Rep. 2016;20(3):17. doi:10.1007/s11916-016-0548-x.
Calkins AM, Gudin J, Gidal B, Jaros MJ, Kim R, Shang G. Impact of Data Imputation Methodology on Pain Assessment over 24 Hours in a Randomized, Placebo-Controlled Study of Gabapentin Enacarbil in Patients with Neuropathic Pain Associated with Postherpetic Neuralgia. Pain Med. January 2016:pnv072. doi:10.1093/pm/pnv072.
Lee EG, Lee HJ, Hyun DJ, Min K, Kim DH, Yoon MS. Efficacy of low dose gabapentin in acute herpes zoster for preventing postherpetic neuralgia: a prospective controlled study. Dermatol Ther. 2016;29(3):184-190. doi:10.1111/dth.12331.
Anghelescu DL, Steen BD, Wu H, et al. Prospective study of neuropathic pain after definitive surgery for extremity osteosarcoma in a pediatric population. Pediatr Blood Cancer. 2017;64(3):e26162. doi:10.1002/pbc.26162.
Yuan M, Zhou H, Xiao Z, et al. Efficacy and Safety of Gabapentin vs. Carbamazepine in the Treatment of Trigeminal Neuralgia: A Meta-Analysis. Pain Pract. 2016;16(8):1083-1091. doi:10.1111/papr.12406.
Schuller Y, Linthorst GE, Hollak CEM, Van Schaik IN, Biegstraaten M. Pain management strategies for neuropathic pain in Fabry disease--a systematic review. BMC Neurol. 2016;16:25. doi:10.1186/s12883-016-0549-8.
Wanigasekera V, Mezue M, Andersson J, Kong Y, Tracey I. Disambiguating Pharmacodynamic Efficacy from Behavior with Neuroimaging: Implications for Analgesic Drug Development. Anesthesiology. 2016;124(1):159-168. doi:10.1097/ALN.0000000000000924.
Callegari C, Ielmini M, Bianchi L, Lucano M, Bertù L, Vender S. Antiepileptic drug use in a nursing home setting: a retrospective study in older adults. Funct Neurol. 2016;31(2):87-93. doi:10.11138/FNEUR/2016.31.2.087.
Safaeian P, Mattie R, Hahn M, Plastaras CT, Mccormick ZL. Novel Treatment of Radicular Pain With a Multi-Mechanistic Combination Topical Agent: A Case Series and Literature Review. Anesth Pain Med. 2016;6(2). doi:10.5812/aapm.33322.
Robertson KL, Marshman LAG. Gabapentin Superadded to a Pre-Existent Regime Containing Amytriptyline for Chronic Sciatica. Pain Med. 2016;17(11):2095-2099. doi:10.1093/pm/pnw052.
Baron R, Binder A, Attal N, Casale R, Dickenson AH, Treede R-D. Neuropathic low back pain in clinical practice. Eur J Pain. 2016;20:861-873. doi:10.1002/ejp.838.
Cragg JJ, Haefeli J, Jutzeler CR, et al. Effects of Pain and Pain Management on Motor Recovery of Spinal Cord-Injured Patients: A Longitudinal Study. Neurorehabil Neural Repair. 2016;30(8):753-761. doi:10.1177/1545968315624777.
Robertson K, Marshman LAG, Plummer D. Pregabalin and gabapentin for the treatment of sciatica. J Clin Neurosci. 2016;26:1-7. doi:10.1016/j.jocn.2015.05.061.
Allegri M, Baron R, Hans G, et al. A pharmacological treatment algorithm for localized neuropathic pain. Curr Med Res Opin. 2016;32(2):377-384. doi:10.1185/03007995.2015.1129321.
Garland EL. Pain processing in the human nervous system: a selective review of nociceptive and biobehavioral pathways. Prim Care. 2012;39(3):561-571. doi:10.1016/j.pop.2012.06.013.
Vlaskovska M, Surcheva S, Kasakov L. Cancer pain: Mechanisms based personalized analgesia. Auton Autacoid Pharmacol. 2010;30 (2):154-157. doi:http://dx.doi.org/10.1111/j.1474-8673.2010.00454.x.
Woolf CJ. What is this thing called pain? J Clin Invest. 2010;120(11):3742-3744. doi:10.1172/JCI45178.
Jackson IKC. Pharmacotherapy for neuropathic pain. Pain Pract. 2006;6(1):27-33. doi:http://dx.doi.org/10.1111/j.1533-2500.2006.00055.x.
Ossipov MH, Morimura K, Porreca F. Descending pain modulation and chronification of pain. Curr Opin Support Palliat Care. 2014;8(2):143-151. doi:10.1097/SPC.0000000000000055.
McDougall JJ, Samuel E, Sherrington C, et al. Arthritis and Pain. Neurogenic origin of joint pain. Arthritis Res Ther. 2006;8(6):220. doi:10.1186/ar2069.
Omoigui S. The Biochemical Origin of Pain – Proposing a new law of Pain: The origin of all Pain is Inflammation and the Inflammatory Response PART 1 of 3 – A unifying law of pain. doi:10.1016/j.mehy.2006.11.028.
Pain management strategies can alleviate persistent non-malignant pain and minimise the risk of adverse events in the elderly. Drugs Ther Perspect. 2005;21(2):15-19. doi:10.2165/00042310-200521020-00005.
Argoff C. Mechanisms of pain transmission and pharmacologic management. Curr Med Res Opin. 2011;27(10):2019-2031. doi:http://dx.doi.org/10.1185/03007995.2011.614934.
Markman JD, Jensen TS, Semel D, et al. Effects of Pregabalin in Patients with Neuropathic Pain Previously Treated with Gabapentin: A Pooled Analysis of Parallel-Group, Randomized, Placebo-Controlled Clinical Trials. Pain Pract. September 2016. doi:10.1111/papr.12516.
Athanasakis K, Petrakis I, Karampli E, Vitsou E, Lyras L, Kyriopoulos J. Pregabalin versus gabapentin in the management of peripheral neuropathic pain associated with post-herpetic neuralgia and diabetic neuropathy: a cost effectiveness analysis for the Greek healthcare setting. BMC Neurology. 2013;13:56. doi:10.1186/1471-2377-13-56.
Singh P, Kuo B. Central Aspects of Nausea and Vomiting in GI Disorders. Curr Treat Options Gastroenterol. 2016;14(4):444-451. doi:10.1007/s11938-016-0107-x.
Parsons KA, Derkits ME. Visual hallucinations associated with gabapentin use. Am J Health Syst Pharm. 2016;73(10):631-634. doi:10.2146/ajhp150136.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Arquivos Catarinenses de Medicina
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
