Effectiveness of amitriptyline and lamotrigine in traumatic spinal cord injury-induced neuropathic pain: A randomized longitudinal comparative study

Abstract

Study design: Randomized longitudinal comparative study.Objectives: To compare the efficacy of lamotrigine and amitriptyline in the management of traumatic spinal cord injury (SCI)-induced neuropathic pain (NP).Setting: Sawai Man Singh Medical College and Hospital, Jaipur, India.Methods: A total of 147 individuals with NP were randomized for a 3-week trial of either amitriptyline or lamotrigine. Amitriptyline was administered orally at doses of 25, 50 and 100 mg once daily at night time, and lamotrigine was administered orally at doses of 25, 50 and 100 mg twice daily, both for 1 week by means of optional titration. Assessment of NP was done at baseline and thereafter at 1, 2 and 3 weeks using Short-form MC Gill Pain Questionnaire-2 (SFMPQ2) scores.Results: There was a significant difference between the mean values of the SFMPQ2 score at baseline and those at each follow-up for amitriptyline. Similar results were seen in the lamotrigine group. When the differences in mean SFMPQ2 scores at different time frames from baseline were compared with those of the other group, values were found to be nonsignificant as seen on the Mann-Whitney U-test.Conclusions: These findings support the use of both amitriptyline and lamotrigine in the management of NP after traumatic SCI.