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document
Efficacy of venlafaxine XR for the treatment of pain in patients with spinal cord injury and major depression : a randomized , controlled trial . OBJECTIVES To ( 1 ) determine 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 ( RCT ) on the efficacy of venlafaxine XR for major depressive disorder ( MDD ) ( primary aim ) ; and ( 2 ) test the hypothesis that venlafaxine XR would be effective for both neuropathic and nociceptive pain . DESIGN Multisite , double-blind , randomized ( 1:1 ) controlled trial with subjects block randomized and stratified by site , lifetime history of substance abuse , and prior history of MDD . SETTING Six Departments of Physical Medicine and Rehabilitation in university-based medical schools . PARTICIPANTS Individuals ( N=123 ) with SCI and major depression between 18 and 64 years of age , at least 1 month post-SCI who also reported pain . INTERVENTION Twelve-week trial of venlafaxine XR versus placebo using a flexible titration schedule . OUTCOME MEASURES A 0-to-10 numeric rating scale for pain , pain interference items of the Brief Pain Inventory ; 30 % and 50 % responders . RESULTS 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 . CONCLUSIONS 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 persons with SCI pain without MDD .
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Intervention_Pharmacological
venlafaxine XR
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Intervention_Pharmacological
venlafaxine XR
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Intervention_Pharmacological
venlafaxine
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Intervention_Pharmacological
venlafaxine
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Intervention_Pharmacological
venlafaxine XR
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Intervention_Control
placebo
69315
Intervention_Physical
flexible titration schedule
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Intervention_Pharmacological
venlafaxine XR
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Intervention_Control
placebo
69318
Intervention_Pharmacological
venlafaxine XR
69319
Intervention_Pharmacological
venlafaxine XR
69320
Intervention_Pharmacological
Venlafaxine XR
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Intervention_Pharmacological
venlafaxine XR
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Outcome_Pain
0-to-10 numeric rating scale for pain , pain interference items of the Brief Pain Inventory ;
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Outcome_Mental
anxiety
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Outcome_Physical
,
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Outcome_Mental
depression
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Outcome_Physical
, and multiple pain sites
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Participant_Condition
patients with spinal cord injury and major depression :
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Participant_Condition
pain ( secondary aim ) in individuals with spinal cord injury ( SCI ) enrolled in a randomized controlled trial ( RCT ) on the efficacy of venlafaxine XR for major depressive disorder ( MDD )
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Participant_Sample-size
( N=123
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Participant_Age
18 and 64 years of age