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Opioids in Post-stroke Pain: A Systematic Review and Meta-Analysis
Conclusions: The limited number of the included studies and their heterogeneity in terms of study design do not support the efficacy of opioids in post-stroke pain and in pain-related outcomes. Large double-blind randomized clinical trials with objective assessment of pain and related symptoms are needed to further investigate this topic.
Source: Frontiers in Pharmacology - November 27, 2020 Category: Drugs & Pharmacology Source Type: research

Pharmacological Management of Central Post-Stroke Pain: A Practical Guide
Abstract Pain is one of the most troublesome sequelae of stroke. Some of this post-stroke pain is caused by the brain lesion itself; this is called central post-stroke pain (CPSP). Although the prevalence of CPSP is low (1–8 %), persistent, often treatment-resistant, painful sensations are a major problem for stroke patients. The pathogenesis of CPSP remains unknown, but suggested underlying causes include hyperexcitation in the damaged sensory pathways, damage to the central inhibitory pathways, or a combination of the two. For pharmacological treatment, amitriptyline, an adrenergic antidepressant, is current...
Source: CNS Drugs - September 1, 2014 Category: Neurology Source Type: research

Although pharmacological treatment may have beneficial effects in central post-stroke pain, it does not abolish the symptoms
Abstract The management of central post-stroke pain is challenging. Amitriptyline is considered the first-line pharmacological choice, with lamotrigine, gabapentin and pregabalin used as alternative therapies. If the therapeutic response with monotherapy is insufficient, combination therapy (e.g. an adrenergic antidepressant plus an antiepileptic) may be considered.
Source: Drugs and Therapy Perspectives - February 4, 2015 Category: Drugs & Pharmacology Source Type: research

Analgesia in Neurocritical Care: An International Survey and Practice Audit*
Conclusions: Opiates and acetaminophen are preferred analgesic agents, and gabapentin is a contextual third choice, in neurocritically ill patients. Other agents are rarely prescribed. The discordance in physician self-reports and objective audits suggest that pain management optimization studies are warranted.
Source: Critical Care Medicine - April 16, 2016 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Top 20 Research Studies of 2022 for Primary Care Physicians
This article summarizes the top 20 research studies of 2022 identified as POEMs (patient-oriented evidence that matters), excluding COVID-19. Statins for primary prevention of cardiovascular disease produce only a small absolute reduction in a person's likelihood of dying (0.6%), having a myocardial infarction (0.7%), or having a stroke (0.3%) over three to six years. Supplemental vitamin D does not reduce the risk of a fragility fracture, even in people with low baseline vitamin D levels or a previous fracture. Selective serotonin reuptake inhibitors are preferred medical therapy for panic disorder, and patients who disco...
Source: American Family Physician - April 13, 2023 Category: Primary Care Authors: Roland Grad Mark H Ebell Source Type: research

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