Gene/Protein Disease Symptom Drug Enzyme Compound
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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Iloprost, a stable prostacyclin analog, was evaluated clinically for its ability to ameliorate the symptoms of peripheral neuropathy associated with diabetes. In an open, nonrandomized trial, 13 diabetic patients with neuropathy but without proliferative retinopathy received an intravenous infusion of Iloprost at a dose of 10 micrograms, at a rate of 0.1 micrograms/kg/h, twice daily for two weeks. The administration of Iloprost relieved the majority of such subjective symptoms as pain, numbness or sensation of cold and to a lesser extent, such autonomic symptoms as dizziness. In contrast, there was little evidence of objective improvement, e.g., in motor nerve conduction velocity. Iloprost treatment significantly inhibited the platelet aggregation rate stimulated by collagen in vitro. In the one patient tested, thermography revealed an increase in skin temperature by more than 2 degrees C. Side effects associated with Iloprost included headache (3 patients) or aggravation of pain in the extremities (2 patients) and could be ameliorated by slowing the infusion rate or by discontinuing the drug (one patient). Iloprost appears to be safe and effective for relieving the symptoms of diabetic neuropathy. Our results provide the rationale for a double-blind, clinical trial in larger populations of diabetics with peripheral neuropathy.
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PMID:Clinical efficacy of a stable prostacyclin analog, iloprost, in diabetic neuropathy. 170 9

A 46-year-old man, presenting with headache, nausea, and lassitude, was diagnosed as having diabetes mellitus and hyponatremia, and admitted to Tohoku University Hospital. Insulin treatment improved the hyperglycemia but aggravated hyponatremia, which was proved to be elicited by the inappropriate secretion of antidiuretic hormone (SIADH). An acute water load failed to suppress ADH release in the supine posture but slightly increased plasma atrial natriuretic peptide (ANP). On the other hand, plasma ADH markedly increased in response to an upright posture, accompanied by a fall in blood pressure and a rise in heart rate. After treatment with droxidopa "a sympathomimetic drug", ambulatory blood pressure gradually increased and hyponatremia disappeared. However, blood pressure and ADH responses to upright posture were not improved by treatment with the drug. Moreover, plasma ADH was still not sufficiently suppressed by acute water loading in the supine position, but plasma ANP markedly increased, thereby resulting in urinary dilution and natriuresis. These results suggest that exaggerated ADH release (SIADH) was brought about by the baroreceptor reflex stimulated by the postural hypotension, and also by the impaired osmoregulation associated with diabetic neuropathy, and that droxidopa improved cardiovascular function and increased ANP release with resultant urinary dilution and natriuresis in spite of slightly increased ADH release.
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PMID:A case of syndrome of inappropriate secretion of antidiuretic hormone associated with diabetes mellitus. 179 39

Conditions in which antidepressants have been used include diabetic neuropathy, postherpetic neuralgia, headaches, arthritis, chronic back pain, cancer, thalamic pain, facial pain, and phantom limb pain. Although much of the available information is derived from inadequately controlled trials, it seems that antidepressants provide analgesia in many of these disorders. The analgesic effects tend to be independent of antidepressant effects, and doses of heterocyclic antidepressants used for analgesia seem to be lower than those considered effective in the treatment of depression. Doses should be started low and gradually increased until the patient reaches the highest tolerable dose. Onset of analgesia is variable, ranging from 1 day to 10 weeks. Common side effects include dry mouth, drowsiness, urinary retention, orthostatic hypotension, and constipation. Optimum dosages and schedules have not been established.
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PMID:Antidepressants in the management of chronic pain syndromes. 214 20

Antidepressants are often effective in the management of chronic pain syndromes. They are most useful for certain types of pain complaints, such as headache, diabetic neuropathy, arthritis and facial pain. The choice of antidepressant depends on the side effects and the patient's ability to tolerate the medication. The dose is usually half of that used in the management of depression.
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PMID:Antidepressants in chronic pain syndromes. 265 May 7

Antidepressant drugs have been used successfully in the treatment of chronic pain syndromes. Clinical trials have supported the use of these drugs for pain and the depression that often accompanies pain syndromes. Although the exact mechanisms of action have not been clearly elucidated, it has been suggested that these agents have analgesic properties independent of their antidepressant effect on mood and behavior. Pain patients without concomitant depression experienced pain relief with antidepressant therapy; these patients represent the most convincing evidence that antidepressant drugs have a direct analgesic effect. Studies presented in this paper support the clinical efficacy of antidepressant medications in the treatment of patients suffering from headaches (migraine, tension, and mixed types), diabetic neuropathy, arthritis, and facial pain. These data also suggest that antidepressant drugs may be effective in the treatment of postherpetic neuralgia, back pain, and pain from mixed etiologies; however, data for these pain syndromes are less clear, and, thus, further testing is required.
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PMID:The future for antidepressants: treatment of pain. 332 Nov 36

Preliminary studies have shown that repeated nasal applications of capsaicin prevented the occurrence of cluster headache attacks. The present study was designed to verify the difference in efficacy of treatment with nasal capsaicin, depending on the side of application. Fifty-two patients affected by episodic form were divided into 2 groups, one receiving the treatment on the same side where the attacks occurred (ipsilateral side), the other on the controlateral side. Eighteen patients with a chronic form alternately received both ipsilateral and controlateral treatments. Seventy percent of the episodic patients, treated on the ipsilateral side, showed a marked amelioration whereas no improvement was noted in the patients treated on the contralateral side. The efficacy of ipsilateral treatment was emphasized by the results obtained in chronic patients. However, in these patients, the maximum period of amelioration lasted no more than 40 days. The difference between the effects of the 2 treatments (contralateral and ipsilateral) was statistically significant in both episodic and chronic sufferers. The efficacy of repeated nasal applications of capsaicin in cluster headache is congruent with previous reports on the therapeutic effect of capsaicin in other pain syndromes (post-herpetic neuralgia, diabetic neuropathy, trigeminal neuralgia) and supports the use of the drug to produce a selective analgesia.
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PMID:Preventative effect of repeated nasal applications of capsaicin in cluster headache. 770 5

In the paper the possibilities of therapeutic use of capsaicin are presented. This drug seems to be very effective in neuralgia after zoster, and less effective in painful diabetic neuropathy. Attempts are also undertaken at its use in cluster headache, trigeminal neuralgia and arthralgia. Confirmation of the effectiveness of the discussed drug in these pain syndromes requires further studies.
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PMID:[Capsaicin in pain therapy]. 771 41

Capsaicin, the most pungent ingredient in red peppers, has been used for centuries to remedy pain. Recently, its role has come under reinvestigation due to evidence that the drug acts selectively on a subpopulation of primary sensory neurons with a nociceptive function. These neurons, besides generating pain sensations, participate through an antidromic activation in the process known as neurogenic inflammation. The first exposure to capsaicin intensely activates these neurons in both senses (orthodromic: pain sensation; antidromic: local reddening, oedema etc.). After the first exposure, the neurons become insensitive to all further stimulation (including capsaicin itself). This evidence led to the proposal of capsaicin as a prototype of an agent producing selective analgesia. This perspective is radically different from previous 'folk medicine' cures, where the drug was used as a counter-irritating agent (i.e. for muscular pain). The new concept requires that capsaicin be repeatedly applied on the painful area to obtain the desensitisation of the sensory neurons. Following this idea, capsaicin has been used successfully in controlling pain in postherpetic neuralgia, diabetic neuropathy and other conditions of neuropathic pain. Furthermore, evidence indicates that capsaicin could also control the pain of osteoarthritis. Finally, repeated applications of the drug to the nasal mucosa result in the prevention of cluster headache attacks. On the basis of this evidence, capsaicin appears to be a promising prototype for obtaining selective analgesia in localised pain syndromes.
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PMID:Peppers and pain. The promise of capsaicin. 917 23

Thirty-one adult diabetic patients with painful distal symmetrical polyneuropathy were treated with low doses of oral trazodone (50 or 100 mg/day). After 2 weeks of therapy, 19 patients (61.3%) experienced symptomatic relief, and 7 (22.6%) experienced complete relief. Although 8 patients (25.8%) discontinued the drug because of side effects, these were relatively minor (dizziness, headache, insomnia). Low-dose trazodone is recommended as an effective treatment option for painful diabetic neuropathy.
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PMID:The use of low-dose trazodone in the treatment of painful diabetic neuropathy. 1050 15

Studies on the psychological assessment and treatment of neuropathic pain conditions, including postherpetic neuralgia (PHN), diabetic neuropathy, complex regional pain syndrome, post spinal cord injury, post amputation, and AIDS-related neuropathy, are reviewed. Although limited information is currently available, the findings are consistent with the larger literature on chronic pain and indicate that the assessment of neuropathic pain needs to include measurement of multiple dimensions of quality of life. Mood, physical and social functioning, and pain-coping strategies such as catastrophizing and social support are all important domains. Clinical trials of psychological interventions have not been reported in the scientific literature. Case series of successful treatment of neuropathic pain are reported, primarily in the area of biofeedback. As with other chronically painful conditions, it is likely that cognitive-behavioral interventions will improve the quality of life in neuropathic pain conditions.
Curr Pain Headache Rep 2001 Apr
PMID:Psychological assessment and treatment of patients with neuropathic pain. 1125 46


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