Abstract | OBJECTIVE: METHODS: A randomized clinical trial conducted from September 2005 to September 2006. Fifty-nine people with clinically definite MS aged 15 to 50 years were randomly allocated to receive an 8-week treatment course of either nortriptyline (10 mg daily increment over 1 week to 50 mg) or self-applied TENS. Response to treatment was assessed at 2, 4, and 8 weeks after commencement of the intervention. RESULTS:
TENS seemed to be equivalent in efficacy to nortriptyline. A significant decrease in visual analog scale scores of pain and/or sensory complaints of the upper extremities occurred in both groups. Of the 29 people treated with TENS, the mean (SD) intensity of pain and/or sensory complaints decreased from 5.3 (1.6) at baseline to 2.8 (1.5) at 8 weeks follow-up (P < 0.001). Correspondingly in the 30 people treated with nortriptyline, the mean (SD) intensity of pain and/or sensory complaints decreased from 4.9 (1.9) to 3.3 (2.1) (P < 0.001). The mean difference in visual analog scale score at 8 weeks follow-up was not significant between the 2 groups (mean difference -0.5; 95% confidence interval, -1.5-0.5). DISCUSSION: This study demonstrates that both nortriptyline and TENS can be effective in reducing the intensity of pain and/or sensory complaints in the upper extremities of people with MS. However given the side-effect profile of nortriptyline, TENS may have some benefits over nortriptyline. This modest reduction in the intensity of pain and/or sensory complaints suggests that physicians should carefully weigh the risk and benefits of nortriptyline and TENS in people with MS with pain and/or sensory complaints.
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Authors | Ahmad Chitsaz, Mohsen Janghorbani, Vahid Shaygannejad, Fereshteh Ashtari, Mojtaba Heshmatipour, Jennifer Freeman |
Journal | The Clinical journal of pain
(Clin J Pain)
Vol. 25
Issue 4
Pg. 281-5
(May 2009)
ISSN: 1536-5409 [Electronic] United States |
PMID | 19590475
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Antidepressive Agents, Tricyclic
- Nortriptyline
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Topics |
- Adolescent
- Adult
- Antidepressive Agents, Tricyclic
(administration & dosage)
- Electric Stimulation Therapy
(methods)
- Female
- Humans
- Male
- Middle Aged
- Multiple Sclerosis
(complications, diagnosis, nursing)
- Nortriptyline
(administration & dosage)
- Pain
(diagnosis, etiology, prevention & control)
- Pain Measurement
- Treatment Outcome
- Upper Extremity
- Young Adult
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