Clinical Trials in Orofacial Neuralgias
Dextromethorphan
Enfermedades del Nervio Craneal+12
+ Enfermedades del Nervio Facial
+ Enfermedades Estomatognáticas
Estudio de Tratamiento
Resumen
Fecha de inicio: 1 de diciembre de 1997
Fecha en la que se inscribió al primer participante.Some of the clinical features of trigeminal and other facial neuralgias suggest that these painful disorders may be associated with sensitization of central nervous system neurons. Laboratory evidence has shown that central sensitization can be produced and maintained by excitatory amino acids (e.g. glutamate) acting on neurons at NMDA and AMPA/kainate receptor sites. Given this information, and the need for more effective treatments of orofacial neuropathic pain syndromes, two possible candidates worthy of study are 1) dextromethorphan, an NMDA receptor antagonist and 2) topiramate, an anticonvulsant drug with AMPA/kainate receptor blocking activity. Thus, the purpose of this study is to evaluate the efficacy and safety of topiramate (TPM) or high-dose dextromethorphan (DM) versus placebo in the treatment of pain in patients with trigeminal neuralgia (TN) and other orofacial neuropathic pain syndromes. We propose two 6 month studies respectively evaluating dextromethorphan (60 patients; at least 20 with TN, 20 with definite trigeminal nerve pathology and 20 with likely trigeminal nerve pathology) and topiramate (40 patients; at least 20 with TN, 20 with definite trigeminal nerve pathology). These will be double-blind randomized crossover designs comparing high-dose dextromethorphan (DM) versus lorazepam (LOR) (as an active placebo) OR topiramate versus inactive placebo. The primary study outcome measure (in both parts) will be overall daily pain assessed by Gracely pain intensity descriptors. Other recorded data will include adverse drug effects, the frequency, severity and duration of pain paroxysms and a questionnaire focusing on daily function (modification of the Brief Pain Inventory).
Protocolo
Esta sección proporciona detalles del plan del estudio, incluyendo cómo está diseñado y qué se está evaluando.Se reclutarán 100 pacientes
Número total de participantes que el ensayo clínico espera reclutar.Estudio de Tratamiento
Elegibilidad
Los investigadores buscan pacientes que cumplan ciertos criterios, conocidos como criterios de elegibilidad: estado general de salud o tratamientos previos.Cualquier sexo
Sexo biológico de los participantes elegibles para inscribirse.Voluntarios sanos no permitidos
Indica si personas sanas, sin la condición que se estudia, pueden participar.Condiciones
Patología
Criterios
Facial neuralgia, not explained by bone, soft tissue or mucosal lesions. Experiencing daily moderate pain or daily paroxysms of pain unremitting for at least 3 months. Previous trial of an antineuralgic medication. Patients entering the study on other analgesic medications must either continue them as a stable regimen throughout the study period or discontinue them 2 weeks prior to starting the initial pain diary. Adults aged 18 to 89. Serum laboratory results obtained at study entry: Liver function tests: ALT/AST less than 1.2 times upper limit of normal; Creatinine less than 1.5 times upper limit of normal; Negative serum betaHCG for women of childbearing age. Adequate birth control (e.g., oral contraceptives, Norplant) for all women of child-bearing age. Sufficient cognitive function and English language skills to complete questionnaires and communicate verbally with the nursing staff to permit titration of the study drugs. No presence of a painful condition as severe as, but distinct from their orofacial pain condition. No pregnant or lactating women. Patients must not have end-stage renal or hepatic disease. Patients must not have moderate to severe heart disease (MI within preceding year, unstable angina or congestive heart failure). No signs or symptoms of any central neurologic disorder (including seizures). No psychological/psychiatric disorder as identified by a pre-study entry psychiatric assessment. Patients must not have hypersensitivity or intolerance to dextromethorphan, topiramate or the active placebo. No chronic substance abuse, including alcoholism. Patients must have a primary physician. Subjects must not have received an experimental drug or used and experimental device within 30 days.
Centros del Estudio
Estos son los hospitales, clínicas o centros de investigación donde se lleva a cabo el estudio. Puedes encontrar la ubicación más cercana a ti y su estado de reclutamiento.Este estudio tiene una ubicación
National Institute of Dental And Craniofacial Research (NIDCR)
Bethesda, United StatesAbrir National Institute of Dental And Craniofacial Research (NIDCR) en Google Maps