• Neurology · Apr 2003

    Randomized Controlled Trial Comparative Study Clinical Trial

    Venlafaxine versus imipramine in painful polyneuropathy: a randomized, controlled trial.

    • S H Sindrup, F W Bach, C Madsen, L F Gram, and T S Jensen.
    • Department of Neurology, University Hospitals, Odense, Denmark. s.sindrup@dadlnet.dk
    • Neurology. 2003 Apr 22;60(8):1284-9.

    BackgroundTricyclic antidepressants (TCA) are often used in the treatment of painful polyneuropathy. Venlafaxine is a serotonin and weak noradrenaline reuptake inhibitor antidepressant with a different profile of other pharmacologic actions from those of TCA.ObjectiveTo test if venlafaxine would relieve painful polyneuropathy and compare its possible efficacy with that of the TCA imipramine.MethodsThe study design was randomized, double blind, and placebo controlled, with a three-way crossover. Forty patients were assigned to one of the treatment sequences, and 29 completed all three study periods. The daily doses were venlafaxine 225 mg and imipramine 150 mg. During the three treatment periods, each of 4 weeks' duration, patients rated pain paroxysms, constant pain, and touch- and pressure-evoked pain by use of 0- to 10-point numeric rating scales.ResultsThe sum of the individual pain scores during treatment week 4 was lower on venlafaxine (80% of baseline score; p = 0.006) and imipramine (77%; p = 0.001) than on placebo (100%) and did not show any statistical difference between venlafaxine and imipramine (p = 0.44). The individual pain scores for pain paroxysms, constant pain, and pressure-evoked pain showed a similar pattern, whereas touch-evoked pain was uncommon and was not altered by any of the drugs. Numbers needed to treat to obtain one patient with moderate or better pain relief were 5.2 for venlafaxine and 2.7 for imipramine.ConclusionVenlafaxine relieves pain in polyneuropathy and may be as effective as imipramine.

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