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- Title
Divalproex sodium in the management of post-herpetic neuralgia: a randomized double-blind placebo-controlled study.
- Authors
D.K. Kochar; P. Garg; R.A. Bumb; S.K. Kochar; R.D. Mehta; R. Beniwal; N. Rawat
- Abstract
Background: Post-herpetic neuralgia is difficult to treat. Divalproex sodium (valproic acid and sodium valproate in molar ratio 1:1) has been used successfully in the management of various painful neuropathies.Aim: To study the effectiveness and safety of divalproex sodium in the management of post-herpetic neuralgia.Design: Randomized double-blind placebo-controlled trial.Methods: We enrolled 48 consecutively attending out-patients with post-herpetic neuralgia, out of whom three were excluded (two had insufficient pain, one withdrew consent). Quantification of pain was by Short Form-McGill pain questionnaire (SF-MPQ), visual analogue scale (VAS), present pain intensity score (PPI) and 11 point Likert scale (11 PLS) at the beginning of the study, after 2 weeks, 4 weeks and at the end of the study (8 weeks). We also assessed patients' global impression of change by questionnaire at the end of the study.Results: After 8 weeks treatment with 1000?mg/day divalproex sodium, there was significant reduction in pain: SF-MPQ, 20.47 2.29 to 11.90? 6.52 (p < 0.0001); PPI 4.0 0.52 to 1.95 1.29 (p < 0.0001); VAS 70.17 9.21 to 31.27 29.74 (p < 0.0001) and 11 PLS 6.97 0.73 to 3.63 2.34 (p < 0.0001) in comparison to placebo (means SEM). The global impression of change questionnaire showed much or moderate improvement in pain in 58.2% of patients receiving divalproex vs. 14.8% of those receiving placebo. The drug was well tolerated by all patients, except one who developed severe vertigo after 10 days of treatment.Discussion: Divalproex sodium provides significant pain relief in patients of post-herpetic neuralgia, with very little incidence of adverse reactions. These data provide a basis for longer trials in a larger group of patients.
- Subjects
PLACEBOS; ACETIC acid; PAIN; THERAPEUTICS
- Publication
QJM: An International Journal of Medicine, 2005, Vol 98, Issue 1, p29
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hci005