Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 12 , Pages 1547-1560 , December 2007

Comparison of the Effectiveness of Amitriptyline and Gabapentin on Chronic Neuropathic Pain in Persons With Spinal Cord Injury

Presented to the American Pain Society, May 2006, San Antonio, TX, and the American Association of Spinal Cord Injury Psychologists and Social Workers, September 2006, Las Vegas, NV.

  • Diana H. Rintala, PhD

      Affiliations

    • Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
    • Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
    • Corresponding Author InformationReprint requests to Diana H. Rintala, PhD, MEDVAMC (153), 2002 Holcombe Blvd, Houston, TX 77030
  • ,
  • Sally Ann Holmes, MD

      Affiliations

    • Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
    • Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
  • ,
  • Daisy Courtade, MA

      Affiliations

    • Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
    • Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
  • ,
  • Richard Neil Fiess

      Affiliations

    • Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
    • Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
  • ,
  • Luz Viviana Tastard, MD

      Affiliations

    • Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
    • Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
  • ,
  • Paul G. Loubser, MD

      Affiliations

    • Bayshore Medical Center, Pasadena, TX.

  • Image Result

    Profile of the study. There were 6 random assignment groups that differed only with respect to the order in which the medications were received. Twenty-two completed all 3 phases; 26 completed the gab

    Profile of the study. There were 6 random assignment groups that differed only with respect to the order in which the medications were received. Twenty-two completed all 3 phases; 26 completed the gabapentin phase, 28 the amitriptyline phase, and 25 the diphenhydramine phase. Abbreviations: A, amitriptyline; D, diphenhydramine; G, gabapentin.

  • Image Result
    Means and error bars (±2 standard error) of VAS ratings of pain intensity on average during week 8 of each medication by the 22 participants who completed all 3 phases of the study (completers) within

    Means and error bars (±2 standard error) of VAS ratings of pain intensity on average during week 8 of each medication by the 22 participants who completed all 3 phases of the study (completers) within the depressive symptomatology groups.

  • Image Result
    Mean pain intensity ratings on the VAS across time for each study medication within the depressive symptomatology groups.

    Mean pain intensity ratings on the VAS across time for each study medication within the depressive symptomatology groups.

  • Image Result
    Mean pain intensity ratings on the NRS across time for each study medication within the depressive symptomatology groups.

    Mean pain intensity ratings on the NRS across time for each study medication within the depressive symptomatology groups.

  • Image Result
    Mean decrease in average pain intensity ratings on the VAS from baseline to week 8 of each medication within the depressive symptomatology groups.

    Mean decrease in average pain intensity ratings on the VAS from baseline to week 8 of each medication within the depressive symptomatology groups.

  • Image Result
    Mean percent change in average pain intensity ratings on the VAS from baseline to week 8 of each medication within depressive symptomatology groups.

    Mean percent change in average pain intensity ratings on the VAS from baseline to week 8 of each medication within depressive symptomatology groups.

  • Image Result
    Mean CESD-SF scores across time for each medication within the depressive symptomatology groups.

    Mean CESD-SF scores across time for each medication within the depressive symptomatology groups.

  • Image Result
    Dropout rate across time for each medication.

    Dropout rate across time for each medication.

  • Image Result
    Average pain intensity ratings on the VAS during amitriptyline treatment by the 22 completers and by all available ratings for amitriptyline at each time point. Sample sizes for the “All” points varie

    Average pain intensity ratings on the VAS during amitriptyline treatment by the 22 completers and by all available ratings for amitriptyline at each time point. Sample sizes for the “All” points varied depending on dropout and early withdrawal rates.

  • Image Result
    Average pain intensity ratings on the VAS during gabapentin treatment by the 22 completers and by all available ratings for gabapentin at each time point. Sample sizes for the “All” points varied depe

    Average pain intensity ratings on the VAS during gabapentin treatment by the 22 completers and by all available ratings for gabapentin at each time point. Sample sizes for the “All” points varied depending on dropout and early withdrawal rates.

  • Image Result
    Average pain intensity ratings on the VAS during diphenhydramine treatment by the 22 completers and by all available ratings for diphenhydramine at each time point. Sample sizes for the “All” points v

    Average pain intensity ratings on the VAS during diphenhydramine treatment by the 22 completers and by all available ratings for diphenhydramine at each time point. Sample sizes for the “All” points varied depending on dropout and early withdrawal rates.

  • Image Result
    Average pain intensity ratings on the VAS for week 8 by the order in which each medication was received according to randomly assigned group.

    Average pain intensity ratings on the VAS for week 8 by the order in which each medication was received according to randomly assigned group.

  • Image Result
    Frequency distribution of the number of oxycodone-acetaminophen tablets taken for breakthrough pain during week 8 for each medication within the depressive symptomatology groups.

    Frequency distribution of the number of oxycodone-acetaminophen tablets taken for breakthrough pain during week 8 for each medication within the depressive symptomatology groups.

 Supported by the Department of Veterans Affairs, Veterans Health Administration, Rehabilitation Research and Development Service (grant no. B2573R).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)01541-9

doi: 10.1016/j.apmr.2007.07.038

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 12 , Pages 1547-1560 , December 2007