Multiple sclerosis and pain

Multiple sclerosis is a chronic neurodegenerative progressive disease of the central nervous system, which is characterized by multiple foci of demyelination. The total number of people with multiple sclerosis exceeded 2.8 million. Most physicians focus attention on the movement and coordination disorders of patients with multiple sclerosis, but pain is one of the most common symptoms which is observed in about ⅔ of cases of multiple sclerosis. Since pain is a significant limiting factor in the patient’s everyday activity that affects the physical and emotional state of a person, the dilemma of pain management is an actual medico-social problem in medical practice. Multiple sclerosis presents with primary headache, musculoskeletal pain, and neuropathic pain. Neuropathic pain of both central and peripheral genesis has a complex mechanism of occurrence. This review analyzed the types of pharmacological correction of neuropathic pain for the use of tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, anticonvulsants and cannabinoids, taking into account dosage, the pharmacokinetics of drugs, adverse reactions and concomitant pathology.

References

1. Mirabelli E., Elkabes S. (2021) Neuropathic Pain in Multiple Sclerosis and Its Animal Models: Focus on Mechanisms, Knowledge Gaps and Future Directions, 12: 793745.doi: 10.3389/fneur.2021.793745.
2. Simkins T.J., Duncan G.J., Bourdette D. (2021) Chronic demyelination and axonal degeneration in multiple sclerosis: pathogenesis and therapeutic implications. Curr. Neurol. Neurosci. Rep., 21: 26. DOI: 10.1007/s11910-021-01110-5.
3. The Multiple Sclerosis International Federation (2020) Atlas of MS, 3rd Edition.
4. Міщенко Т.С., Шульга О.Д., Бобрик Н.В., Шульга Л.А. (2014) Розсіяний склероз: глобальні перспективи. Укр. мед. часопис, 3(101): https://www.umj.com.ua/article/75523.
5. Басманов С.Н. (1998) Механизмы боли и анальгетики. Фарм. вісн., 4: 41–44.
6. Нефьодов О.О., М’ясоєд Ю.П., Соломенко М.В. та ін. (2021) Фармакологія антиноцицепції за умов експериментального еквіваленту розсіяного склерозу. Вісн. пробл. біол. мед., 3(161): 131–136.
7. Marrie R.A., Reingold S., Cohen J. et al. (2015) The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic review. Mult. Scler., 21: 305–317. DOI: 10.1177/1352458514564487.
8. Нефьодов О.О., Кальбус O.I. (2022) Механізми виникнення та хронізації нейропатичного болю при розсіяному склерозі в клінічних та експериментальних умовах. Укр. мед. часопис, 1–2 (147–148): https://www.umj.com.ua/article/226789.
9. D’Amico D., La Mantia L., Rigamonti A. et al. (2004) Prevalence of primary headaches in people with multiple sclerosis. Cephalalgia, 24: 980–984.
10. Vacca G., Marano E., Brescia-Morra V. et al. (2007) Multiple sclerosis and headache co-morbidity: a case-control study. Neurol. Sci., 28: 133–135.
11. Villani V., Prosperini L., Ciuffoli A. et al. (2008) Primary headache and multiple sclerosis: preliminary results of a prospective study. Neurol. Sci., 29(Suppl. 1): S146–S148.
12. Nicoletti A., Patti F., Lo Fermo S. et al. (2008) Headache and multiple sclerosis: a population-based case-control study in Catania, Sicily. Cephalalgia, 28: 1163–1169.
13. Martinelli-Boneschi F., Colombo B., Martinelli V. et al. (2008) Lifetime and actual prevalence of pain and headache in multiple sclerosis. Mult. Scler., 14: 514–521.
14. Putzki N., Pfriem A., Limmroth V. et al. (2009) Prevalence of migraine, tension type headache and trigeminal neuralgia in multiple sclerosis. Eur. J. Neurol., 16: 262–267.
15. Kister I., Caminero A.B., Monteith T.S. et al. (2010) Migraine is comorbid with multiple sclerosis and associated with a more symptomatic MS course. J. Headache Pain, 11: 417–425.
16. O’Connor A.B., Schwid S.R., Herrmann D.N. et al. (2008) Pain associated with multiple sclerosis: systematic review and proposed classification. Pain, 137: 96–111.
17. Grau-López L., Sierra S., Martínez-Cáceres E., Ramo-Tello C. (2011) Analysis of the pain in multiple sclerosis patients. Neurologia, 26: 208–213.
18. Al-Araji A.H., Oger J. (2005) Reappraisal of lhermitte’s sign in multiple sclerosis. Mult. Scler., 11: 398–402.
19. Khan N., Smith M.T. (2014) Multiple sclerosis-induced neuropathic pain: pharmacological management and pathophysiological insights from rodent EAE models. Inflammopharmacol., 22: 1–22.
20. Van den Broeke E.N. (2018) Central sensitization and pain hypersensitivity: some critical considerations. F1000Res., 7: 1325. DOI: 10.12688/f1000 research.15956.2.
21. Baron R., Hans G., Dickenson A.H. (2013) Peripheral input and its importance for central sensitization. Ann. Neurol., 74: 630–636. DOI: 10.1002/ana.24017.
22. Tao Y.X. (2012) AMPA receptor trafficking in inflammation-induced dorsal horn central sensitization. Neurosci. Bull., 28: 111–120. DOI: 10.1007/s12264-012-1204-z.
23. Latremoliere A., Woolf C.J. (2009) Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J. Pain, 10: 895–926. DOI: 10.1016/j.jpain.2009.06.012.
24. Gautam M., Prasoon P., Kumar R. et al. (2016) Role of neurokinin type 1 receptor in nociception at the periphery and the spinal level in the rat. Spinal. Cord, 54: 172–182. DOI: 10.1038/sc.2015.206.
25. Barker P.A., Mantyh P., Arendt-Nielsen L. et al. (2020) Nerve growth factor signaling and its contribution to pain. J. Pain Res., 13: 1223–1241. DOI: 10.2147/JPR.S247472.
26. Finnerup N.B., Otto M., McQuay H.J. et al. (2005) Algorithm for neuropathic pain treatment: an evidence based proposal. Pain, 118: 289–305.
27. Finnerup N.B., Sindrup S.H., Jensen T.S. (2010) The evidence for pharmacological treatment of neuropathic pain. Pain, 150: 573–581.
28. Saarto T., Wiffen P.J. (2010) Antidepressants for neuropathic pain: a Cochrane review. J. Neurol. Neurosurg. Psychiatry, 81: 1372–1733.
29. Max M.B., Kishore-Kumar R., Schafer S.C. et al. (1991) Efficacy of desipramine in painful diabetic neuropathy: a placebo-controlled trial. Pain, 45: 3–9.
30. Max M.B., Lynch S.A., Muir J. et al. (1992) Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy. N. Engl. J. Med., 326: 1250–1256.
31. Ollat H., Cesaro P. (1995) Pharmacology of neuropathic pain. Clin. Neuropharmacol., 18: 391–404.Joss J.D. (1999) Tricyclic antidepressant use in diabetic neuropathy. Ann. Pharmacother., 33: 996–1000.
32. Gahimer J., Wernicke J., Yalcin I. et al. (2007) A retrospective pooled analysis of duloxetine safety in 23983 subjects. Curr. Med. Res. Opin., 23: 175–184.
33. Sultan A., Gaskell H., Derry S., Moore R.A. (2008) Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials. BMC Neurology, 8: 29.
34. Goodman L.S., Brunton L.L., Chabner B., Knollmann B.C (2001) Goodman and Gilman’s pharmacological basis of therapeutics. New York, McGraw-Hill. pp. 459–461.
35. Rowbotham M.C., Goli V., Kunz N.R. et al. (2004) Venlafaxine extended release in the treatment of painful diabetic neuropathy: a double blind, placebo-controlled study. Pain, 110: 697–706.
36. Kajdasz D.K., Iyengar S., Desaiah D. et al. (2007) Duloxetine for the management of diabetic peripheral neuropathic pain: evidence-based findings from post hoc analysis of three multicenter, randomized, double-blind, placebo-controlled, parallel-group studies. Clin. Ther., 29 (Suppl.): 2536–2546.
37. Gilron I., Bailey J.M., Tu D. et al. (2009) Nortriptyline and gabapentin, alone and in combination for neuropathic pain: a double-blind, randomised crossover trial. Lancet, 374: 1252–1261.
38. Bockbrader H.N., Wesche D., Miller R. et al. (2010) A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin. Pharmacokinet., 49: 661–669.
39. O’Connor A.B., Dworkin R.H. (2009) Treatment of neuropathic pain: an overview of recent guidelines. Am. J. Med., 10 (suppl.): s22–s32.
40. Gallagher R.M., Pasol E. (1997) Psychopharmacologic drugs in the chronic pain syndromes. Curr. Rev. Pain, 1: 138–152.
41. Loughrey J.P.R., Smith H.S. (2003) Anticonvulsant drugs in the treatment of chronic pain states. Philadelphia, Elsevier, p. 165–182.
42. Killian J.M., Fromm G.H. (1968) Carbamazepine in the treatment of neuralgia. Arch. Neurol., 19: 129–136.
43. Simpson D.M., Olney R., McArthur J.C. et al. (2000) A placebo-controlled trial of lamotrigine for painful HIV-associated neuropathy. Neurology, 54: 2115–2119.
44. Eisenberg E., Lurie Y., Braker C. et al. (2001) Lamotrigine reduces painful diabetic neuropathy: a randomized, controlled study. Neurology, 57: 505–509.
45. Thienel U., Neto W., Schwabe S.K., Vijapurjar U. (2004) Topiramate Diabetic Neuropathic Pain Study Group. Topiramate in painful diabetic polyneuropathy: findings from three double-blind placebo controlled trials. Acta Neurol. Scand.,110: 221–231.
46. Abboud H., Hill E., Siddiqui J. et al. (2017) Neuromodulation in multiple sclerosis. Mult. Scler., 23: 1663–1676.
47. Young J., Zoghi M., Khan F., Galea M.P. (2020) The effect of transcranial direct current stimulation on chronic neuropathic pain in patients with multiple sclerosis: randomized controlled trial. Pain Medicine, 21: 3451–3457. DOI: 10.1093/pm/pnaa128.
48. Klein J., Siepmann T., Schackert G. et al. (2020) Peripheral nerve field stimulation in medically refractory trigeminal neuralgia attributed to multiple sclerosis. J. Neurosurg., 134: 1244–1250.
49. Thorsten R. (2019) Cannabis for Neuropathic Pain in Multiple Sclerosis — High Expectations, Poor DataFront Pharmacol., 10: 1239. doi: 10.3389/fphar.2019.01239.
50. Robson P. (2001) Therapeutic aspects of cannabis and cannabinoids. Br. J. Psychiatry, 178: 107–115. doi: 10.1192/bjp.178.2.107. PMID: 11157423.
51. Radwan M.M., Chandra S., Gul S., Elsohly M.A. (2021) Cannabinoids, Phenolics, Terpenes and Alkaloids of Cannabis. Molecules, 26: 2774.
52. Jones É., Vlachou S. (2020) A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis. Treatment Molecules, 25(21): 4930. doi: 10.3390/molecules25214930.
53. Filippini G., Minozzi S., Borrelli F. et al. (2022) Cannabis and cannabinoids for people with multiple sclerosis. Cochrane Database Syst. Rev., 5(5): CD013444. doi: 10.1002/14651858.CD013444.pub2.
54. Rog D.J., Nurmikko T.J., Friede T., Young C. (2005) Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology, 65: 812–819.
55. Dykukha I., Malessa R., Essner U., Überall M.A. (2021) Nabiximols in chronic neuropathic pain: A meta-analysis of randomized placebo-controlled trials. Pain Med., 22: 861–874.
56. Schimrigk S., Marziniak M., Neubauer C. et al. (2017) Dronabinol is a safe long-term treatment option for neuropathic pain patients. Eur. Neurol., 78: 320–329.
57. Whiting P.F., Wolff R.F., Deshpande S. et al. (2015) Cannabinoids for medical use: a systematic review and meta-analysis. JAMA, 313: 2456–2473.
58. Turcotte D., Doupe M., Torabi M. et al. (2015) Nabilone as an adjunctive to gabapentin for multiple sclerosis-induced neuropathic pain: a randomized controlled trial. Pain Med., 16: 149–159.