Bladder Pain Syndrome Treated with Triple Therapy with Gabapentin, Amitriptyline, and a Nonsteroidal Anti-Inflammatory Drug
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Purpose: Bladder pain syndrome is a chronic disease that manifests as bladder pain, frequency, nocturia, and urgency. Gabapentin, amitriptyline, and nonsteroidal anti-inflammatory drugs are efficacious treatments for bladder pain syndrome. Here, we assessed the effect of triple therapy with these drugs in women with bladder pain syndrome. Methods: Between May 2007 and May 2010, we conducted a prospective nonrandomized study on 74 patients with bladder pain syndrome. Of these patients, 38 (11 men and 27 women; mean age, 55.9 years; range, 25 to 77 years; mean follow-up, 12.6 months) were administered the interstitial cystitis (IC) symptom scales (O’Leary-Sant Symptom Index) and visual analog scale (VAS) 1, 3, and 6 months after treatment to assess the efficacy of triple therapy. Results: The pretreatment O’Leary-Sant IC symptom score was 11.7, and the post-treatment scores were 4.4, 3.8, and 4.0 at 1, 3, and 6 months, respectively; the pretreatment problem index score was 10.5, and the post-treatment scores were 3.7, 2.7, and 2.9 at 1, 3, and 6 months, respectively. The pretreatment VAS score was 6.7, and the post-treatment scores were 1.8, 1.5, and 1.7 at 1, 3, and 6 months, respectively. The O’Leary-Sant IC symptom index and problem index and VAS scores improved considerably 1 month after treatment (P<0.05). However, the results at 1, 3, and 6 months after treatment were not significantly different (P>0.05). Conclusions: Triple therapy was sufficiently effective in patients with bladder pain syndrome and caused no significant adverse effects. However, large-scale studies should be performed to verify our findings.
Abstract
Purpose: Bladder pain syndrome is a chronic disease that manifests as bladder pain, frequency, nocturia, and urgency. Gabapentin, amitriptyline, and nonsteroidal anti-inflammatory drugs are efficacious treatments for bladder pain syndrome. Here, we assessed the effect of triple therapy with these drugs in women with bladder pain syndrome. Methods: Between May 2007 and May 2010, we conducted a prospective nonrandomized study on 74 patients with bladder pain syndrome. Of these patients, 38 (11 men and 27 women; mean age, 55.9 years; range, 25 to 77 years; mean follow-up, 12.6 months) were administered the interstitial cystitis (IC) symptom scales (O’Leary-Sant Symptom Index) and visual analog scale (VAS) 1, 3, and 6 months after treatment to assess the efficacy of triple therapy. Results: The pretreatment O’Leary-Sant IC symptom score was 11.7, and the post-treatment scores were 4.4, 3.8, and 4.0 at 1, 3, and 6 months, respectively; the pretreatment problem index score was 10.5, and the post-treatment scores were 3.7, 2.7, and 2.9 at 1, 3, and 6 months, respectively. The pretreatment VAS score was 6.7, and the post-treatment scores were 1.8, 1.5, and 1.7 at 1, 3, and 6 months, respectively. The O’Leary-Sant IC symptom index and problem index and VAS scores improved considerably 1 month after treatment (P<0.05). However, the results at 1, 3, and 6 months after treatment were not significantly different (P>0.05). Conclusions: Triple therapy was sufficiently effective in patients with bladder pain syndrome and caused no significant adverse effects. However, large-scale studies should be performed to verify our findings.
참고문헌 (21)
- Hanno P, "Status of international consensus on interstitial cystitis", bladder pain syndrome, Neurourol Urodyn, pp.2009, 28[DOI]
- Hanno P, "Bladder Pain Syndrome Committee of the International Consultation on Incontinence", Neurourol Urodyn, 29, pp.191~198 (2010)
- interstitial cystitis and related disorders in: Campbell-Walsh urology. 9nd ed, "Painful bladder syndrome", pp.2007, Hanno PM
- Max MB, "Treatment of post-herpetic neuralgia: antidepressants", Ann Neurol, 35(Suppl), pp.50~53 (1994)
- Richeimer SH, "Utilization patterns of tricyclic antidepressants in a multidisciplinary pain clinic: a survey", Clin J Pain, 13, pp.324~329 (1997)
- Rose MA, "Gabapentin: pharmacology and its use in pain management", Anaesthesia, 57, pp.451~462 (2002)
- Rosenberg JM, "The effect of gabapentin on neuropathic pain", Clin J Pain, 13, pp.251~255 (1997)
- Taylor CP, "Mechanisms of action of gabapentin", Rev Neurol (Paris), 153(Suppl 1), pp.39~45 (1997)
- Roelofs PD, "Nonsteroidal anti-inflammatory drugs for low back pain: an updated Cochrane review", Spine (Phila Pa 1976), 33, pp.1766~1774 (2008)
- Onghena P, "Antidepressant-induced analgesia in chronic non-malignant pain: a meta-analysis of 39 placebo-controlled studies", Pain, 49, pp.205~219 (1992)
- McKay M, "Dysesthetic (“essential”) vulvodynia. Treatment with amitriptyline", J Reprod Med, 38, pp.9~13 (1993)
- Sasaki K, "Oral gabapentin (neurontin) treatment of refractory genitourinary tract pain", Tech Urol, 7, pp.47~49 (2001)
- Ben-David B, "Gabapentin therapy for vulvodynia", Anesth Analg, 89, pp.1459~1460 (1999)
- Vinik A, "Use of antiepileptic drugs in the treatment of chronic painful diabetic neuropathy", J Clin Endocrinol Metab, 90, pp.4936~4945 (2005)
- Sindrup SH, "Antidepressants in the treatment of neuropathic pain", Basic Clin Pharmacol Toxicol, 96, pp.399~409 (2005)
- Sawynok J, "Antidepressants as analgesics: an overview of central and peripheral mechanisms of action", J Psychiatry Neurosci, 26, pp.21~29 (2001)
- Sator-Katzenschlager SM, "Chronic pelvic pain treated with gabapentin and amitriptyline: a randomized controlled pilot study", Wien Klin Wochenschr, 117, pp.761~768 (2005)
- van Ophoven A, "Long-term results of amitriptyline treatment for interstitial cystitis", J Urol, 174, pp.1837~1840 (2005)
- Foster HE Jr, "Effect of amitriptyline on symptoms in treatment naïve patients with interstitial cystitis", painful bladder syndrome, 2010, pp.183, 1853~1858
- Savidge CJ, "Psychological aspects of chronic pelvic pain", J Psychosom Res, 42, pp.433~444 (1997)
- Banks SM, "Explaining high rates of depression in chronic pain: a diathesis-stress framework", Psychol Bull, 119, pp.95~110 (1996)