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Rana MH, Khan AAG, Khalid I, Ishfaq M, Javali MA, Baig FAH, Kota MZ, Khader MA, Hameed MS, Shaik S, Das G. Therapeutic Approach for Trigeminal Neuralgia: A Systematic Review. Biomedicines 2023; 11:2606. [PMID: 37892981 PMCID: PMC10604820 DOI: 10.3390/biomedicines11102606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/05/2023] [Accepted: 09/13/2023] [Indexed: 10/29/2023] Open
Abstract
This umbrella review aimed to determine the various drugs used to treat trigeminal neuralgia (TN) and to evaluate their efficacies as well as side effects by surveying previously published reviews. An online search was conducted using PubMed, CRD, EBSCO, Web of Science, Scopus, and the Cochrane Library with no limits on publication date or patients' gender, age, and ethnicity. Reviews and meta-analyses of randomized controlled trials pertaining to drug therapy for TN, and other relevant review articles added from their reference lists, were evaluated. Rapid reviews, reviews published in languages other than English, and reviews of laboratory studies, case reports, and series were excluded. A total of 588 articles were initially collected; 127 full-text articles were evaluated after removing the duplicates and screening the titles and abstracts, and 11 articles were finally included in this study. Except for carbamazepine, most of the drugs had been inadequately studied. Carbamazepine and oxcarbazepine continue to be the first choice for medication for classical TN. Lamotrigine and baclofen can be regarded as second-line drugs to treat patients not responding to first-line medication or for patients having intolerable side effects from carbamazepine. Drug combinations using carbamazepine, baclofen, gabapentin, ropivacaine, tizanidine, and pimozide can yield satisfactory results and improve the tolerance to the treatment. Intravenous lidocaine can be used to treat acute exaggerations and botulinum toxin-A can be used in refractory cases. Proparacaine, dextromethorphan, and tocainide were reported to be inappropriate for treating TN. Anticonvulsants are successful in managing trigeminal neuralgia; nevertheless, there have been few studies with high levels of proof, making it challenging to compare or even combine their results in a statistically useful way. New research on other drugs, combination therapies, and newer formulations, such as vixotrigine, is awaited. There is conclusive evidence for the efficacy of pharmacological drugs in the treatment of TN.
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Affiliation(s)
- Muhammad Haseeb Rana
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Abdul Ahad Ghaffar Khan
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (A.A.G.K.); (I.K.); (M.I.); (F.A.H.B.); (M.Z.K.)
| | - Imran Khalid
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (A.A.G.K.); (I.K.); (M.I.); (F.A.H.B.); (M.Z.K.)
| | - Muhammad Ishfaq
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (A.A.G.K.); (I.K.); (M.I.); (F.A.H.B.); (M.Z.K.)
| | - Mukhatar Ahmed Javali
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (M.A.J.); (M.A.K.)
| | - Fawaz Abdul Hamid Baig
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (A.A.G.K.); (I.K.); (M.I.); (F.A.H.B.); (M.Z.K.)
| | - Mohammad Zahir Kota
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (A.A.G.K.); (I.K.); (M.I.); (F.A.H.B.); (M.Z.K.)
| | - Mohasin Abdul Khader
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (M.A.J.); (M.A.K.)
| | - Mohammad Shahul Hameed
- Department of Diagnostic Sciences and Oral Biology, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Sharaz Shaik
- Department of Prosthetic Dentistry, Lenora Institute of Dental Sciences, Rajahmundry 533101, India;
| | - Gotam Das
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
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Bicket MC, Durbhakula S. One prescription for the opioid crisis: require buprenorphine waivers for pain medicine fellows. Reg Anesth Pain Med 2019:rapm-2019-100743. [PMID: 31387971 DOI: 10.1136/rapm-2019-100743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/03/2019] [Accepted: 07/22/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Mark C Bicket
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, US
- Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Shravani Durbhakula
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, US
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Balogh M, Zádor F, Zádori ZS, Shaqura M, Király K, Mohammadzadeh A, Varga B, Lázár B, Mousa SA, Hosztafi S, Riba P, Benyhe S, Gyires K, Schäfer M, Fürst S, Al-Khrasani M. Efficacy-Based Perspective to Overcome Reduced Opioid Analgesia of Advanced Painful Diabetic Neuropathy in Rats. Front Pharmacol 2019; 10:347. [PMID: 31024314 PMCID: PMC6465774 DOI: 10.3389/fphar.2019.00347] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/20/2019] [Indexed: 12/20/2022] Open
Abstract
Reduction of the opioid analgesia in diabetic neuropathic pain (DNP) results from μ-opioid receptor (MOR) reserve reduction. Herein, we examined the antinociceptive and antiallodynic actions of a novel opioid agonist 14-O-methymorphine-6-O-sulfate (14-O-MeM6SU), fentanyl and morphine in rats with streptozocin-evoked DNP of 9–12 weeks following their systemic administration. The antinociceptive dose-response curve of morphine but not of 14-O-MeM6SU or fentanyl showed a significant right-shift in diabetic compared to non-diabetic rats. Only 14-O-MeM6SU produced antiallodynic effects in doses matching antinociceptive doses obtained in non-diabetic rats. Co-administered naloxone methiodide (NAL-M), a peripherally acting opioid receptor antagonist failed to alter the antiallodynic effect of test compounds, indicating the contribution of central opioid receptors. Reduction in spinal MOR binding sites and loss in MOR immunoreactivity of nerve terminals in the spinal cord and dorsal root ganglia in diabetic rats were observed. G-protein coupling assay revealed low efficacy character for morphine and high efficacy character for 14-O-MeM6SU or fentanyl at spinal or supraspinal levels (Emax values). Furthermore, at the spinal level only 14-O-MeM6SU showed equal efficacy in G-protein activation in tissues of diabetic- and non-diabetic animals. Altogether, the reduction of spinal opioid receptors concomitant with reduced analgesic effect of morphine may be circumvented by using high efficacy opioids, which provide superior analgesia over morphine. In conclusion, the reduction in the analgesic action of opioids in DNP might be a consequence of MOR reduction, particularly in the spinal cord. Therefore, developing opioids of high efficacy might provide analgesia exceeding that of currently available opioids.
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Affiliation(s)
- Mihály Balogh
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Ferenc Zádor
- Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
| | - Zoltán S Zádori
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Mohammed Shaqura
- Department of Anaesthesiology and Intensive Care Medicine, Charité University Berlin, Berlin, Germany
| | - Kornél Király
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Amir Mohammadzadeh
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Bence Varga
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Bernadette Lázár
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Shaaban A Mousa
- Department of Anaesthesiology and Intensive Care Medicine, Charité University Berlin, Berlin, Germany
| | - Sándor Hosztafi
- Department of Pharmaceutical Chemistry, Semmelweis University, Budapest, Hungary
| | - Pál Riba
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Sándor Benyhe
- Institute of Biochemistry, Biological Research Centre of the Hungarian Academy of Sciences, Szeged, Hungary
| | - Klára Gyires
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Michael Schäfer
- Department of Anaesthesiology and Intensive Care Medicine, Charité University Berlin, Berlin, Germany
| | - Susanna Fürst
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Mahmoud Al-Khrasani
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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Wang B, Su CJ, Liu TT, Zhou Y, Feng Y, Huang Y, Liu X, Wang ZH, Chen LH, Luo WF, Liu T. The Neuroprotection of Low-Dose Morphine in Cellular and Animal Models of Parkinson's Disease Through Ameliorating Endoplasmic Reticulum (ER) Stress and Activating Autophagy. Front Mol Neurosci 2018; 11:120. [PMID: 29731707 PMCID: PMC5920031 DOI: 10.3389/fnmol.2018.00120] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 03/28/2018] [Indexed: 12/02/2022] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disease characterized the progressive loss of dopaminergic (DA) neurons in the substantia nigra pars compacta (SNc). Brain endogenous morphine biosynthesis was reported to be impaired in PD patients and exogenous morphine attenuated 6-hydroxydopamine (6-OHDA)-induced cell death in vitro. However, the mechanisms underlying neuroprotection of morphine in PD are still unclear. In the present study, we investigated the neuroprotective effects of low-dose morphine in cellular and animal models of PD and the possible underlying mechanisms. Herein, we found 6-OHDA and rotenone decreased the mRNA expression of key enzymes involved in endogenous morphine biosynthesis in SH-SY5Y cells. Incubation of morphine prevented 6-OHDA-induced apoptosis, restored mitochondrial membrane potential, and inhibited the accumulation of intracellular reactive oxygen species (ROS) in SH-SY5Y cells. Furthermore, morphine attenuated the 6-OHDA-induced endoplasmic reticulum (ER) stress possible by activating autophagy in SH-SY5Y cells. Finally, oral application of low-dose morphine significantly improved midbrain tyrosine hydroxylase (TH) expression, decreased apomorphine-evoked rotation and attenuated pain hypersensitivity in a 6-OHDA-induced PD rat model, without the risks associated with morphine addiction. Feeding of low-dose morphine prolonged the lifespan and improved the motor function in several transgenic Drosophila PD models in gender, genotype, and dose-dependent manners. Overall, our results suggest that neuroprotection of low-dose morphine may be mediated by attenuating ER stress and oxidative stress, activating autophagy, and ameliorating mitochondrial function.
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Affiliation(s)
- Bing Wang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and the Second Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Cun-Jin Su
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and the Second Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Teng-Teng Liu
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Yan Zhou
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Yu Feng
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and the Second Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Ya Huang
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Xu Liu
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Zhi-Hong Wang
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Li-Hua Chen
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Wei-Feng Luo
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Tong Liu
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and the Second Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Neuroscience, Soochow University, Suzhou, China
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Zhu C, Li W, Xu F, Li M, Yang L, Hu XY, Ye ZX, Wang Z, Luo ZJ. Effects of Ginkgo Biloba Extract EGb-761 on Neuropathic Pain in Mice: Involvement of Opioid System. Phytother Res 2016; 30:1809-1816. [PMID: 27452677 DOI: 10.1002/ptr.5685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 06/20/2016] [Accepted: 06/28/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Chao Zhu
- Institute of Orthopaedics, Xijing Hospital; The Fourth Military Medical University; Xi'an 710032 Shaanxi Province P. R. China
- Department of Orthopaedics; 3 hospital of PLA; Baoji 721004 Shaanxi Province P. R. China
| | - Wei Li
- Department of Orthopaedics, Tangdu Hospital; The Fourth Military Medical University; Xi'an 710000 Shaanxi Province P. R. China
| | - Fan Xu
- The Out-patient Department; 3 hospital of PLA; Baoji 721004 Shaanxi Province P. R. China
| | - Mo Li
- Institute of Orthopaedics, Xijing Hospital; The Fourth Military Medical University; Xi'an 710032 Shaanxi Province P. R. China
| | - Liu Yang
- Institute of Orthopaedics, Xijing Hospital; The Fourth Military Medical University; Xi'an 710032 Shaanxi Province P. R. China
| | - Xue-Yu Hu
- Institute of Orthopaedics, Xijing Hospital; The Fourth Military Medical University; Xi'an 710032 Shaanxi Province P. R. China
| | - Zheng-Xu Ye
- Institute of Orthopaedics, Xijing Hospital; The Fourth Military Medical University; Xi'an 710032 Shaanxi Province P. R. China
| | - Zhe Wang
- Institute of Orthopaedics, Xijing Hospital; The Fourth Military Medical University; Xi'an 710032 Shaanxi Province P. R. China
| | - Zhuo-Jing Luo
- Institute of Orthopaedics, Xijing Hospital; The Fourth Military Medical University; Xi'an 710032 Shaanxi Province P. R. China
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Wiffen PJ, Knaggs R, Derry S, Cole P, Phillips T, Moore RA. Paracetamol (acetaminophen) with or without codeine or dihydrocodeine for neuropathic pain in adults. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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