Pain is an unpleasant sensory and emotional experience that can have a significant impact on a person’s quality of life, general health, psychological health, and social and economic wellbeing. As a result of the disorder, the nerves that carry information between the central nervous system and the rest of the body are damaged, causing pain, tingling, and numbness in the feet and hands. Benfotiamine is not just for diabetics. A 2007 Cochrane review evaluating the effectiveness of aldose reductase inhibitors on progression of diabetic neuropathies found no evidence for effectiveness.8 Ongoing Cochrane protocols are evaluating the effectiveness of several other classes of pharmacologic agents.8-11 However, all of these experimental interventions have not been FDA-approved, are not used in the United States, and thus are not within the scope of our review. With advancing age, the nociceptive pathway undergoes degenerative changes, mainly consisting of axonal loss. Ten weeks after the onset of herpes zoster, bilateral foot drops and numbness of the right foot dorsum developed. Because of structural neural changes, pain can become persistent.
length dependent polyneuropathy). In addition, these results demonstrated that treatment of patients with acute herpes zoster with famciclovir significantly reduced both the duration and prevalence of PHN.18 It may be useful to combine antiviral therapy with treatments directed at PHN pain in patients with herpes zoster infections. Also, on average, up to 47 percent of patients treated with Lyrica experienced a 50 percent reduction in pain, as measured by a standard rating scale. Historical note. The CME Scholar Office of CME Programs has reviewed these disclosures and has determined that the faculty relationships are not inappropriate in the context of the topics discussed and are not inconsistent with the educational goals and integrity of the activity. Indirect comparisons of different treatments are problematic because RCTs differ substantially in research design and outcomes reported. In clinical trials involving epilepsy patients who continue to experience partial seizures despite treatment, adding Lyrica to their standard treatment provided up to 51 percent seizure reduction in patients within the first week of treatment.
The most common treatment-related adverse events were peripheral sensory neuropathy, nausea, fatigue, neutropenia, and diarrhea. The most common adverse events reported by patients with either epilepsy or neuropathic pain were dizziness and somnolence. Most adverse events were mild to moderate in intensity and generally dose related. Examples include the human immunodeficiency virus (HIV) and the herpes zoster virus which causes shingles. The symptoms improved on withdrawal of the statin, but recurred on rechallenge with the original and two other statins as well as niacin.