Efficacy of venlafaxine XR for the treatment of pain in patients with spinal cord injury and major depression: A randomized, controlled trial

Model System:

TBI

Reference Type:

Journal

Accession No.:

J71255

Journal:

Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

2015 , 96, 4, 680-689

Publication Website:

Abstract:

Study investigated the efficacy of venlafaxine XR for the treatment of pain (secondary aim) in individuals with spinal cord injury (SCI) enrolled in a randomized controlled trial on the efficacy of venlafaxine XR for major depressive disorder (MDD) (primary aim). It also tested the hypothesis that venlafaxine XR would be effective for both neuropathic and nociceptive pain. A total of 123 adults with SCI and major depression who also reported pain were randomly assigned to 12 weeks of active treatment (venlafaxine XR) or inactive placebo using a flexible titration schedule. Outcome measures included a 0-to-10 numeric rating scale for pain intensity, and pain interference items of the Brief Pain Inventory. Results indicated that the effect of venlafaxine XR on neuropathic pain was similar to that of placebo. However, venlafaxine XR resulted in statistically significant and clinically meaningful reductions in nociceptive pain site intensity and interference even after controlling for anxiety, depression, and multiple pain sites within the same individual. For those who achieved a minimally effective dose of venlafaxine XR, some additional evidence of effectiveness was noted for those with mixed (both neuropathic and nociceptive) pain sites. Findings suggest that venlafaxine XR could complement current medications and procedures for treating pain after SCI and MDD that has nociceptive features. Its usefulness for treating central neuropathic pain is likely to be limited. Research is needed to replicate these findings and determine whether the antinociceptive effect of venlafaxine XR generalizes to people with SCI pain without MDD.

Author(s):

Richards, J. Scott, Bombardier, Charles H., Wilson, Catherine S., Chiodo, Anthony E., Brooks, Larry, Tate, Denise G., Temkin, Nancy R., Barber, Jason K., Heinemann, Allen W., McCullumsmith, Cheryl, Fann, Jesse R.