Neuropathic pain (NP) has several therapeutic options but efficacy is limited and adverse effects occur, such that additional treatment options are needed.
This research
study shows that Amitriptyline 4% and ketamine 2% (AmiKet) provides a rational
drug combination to conquer the neuropathic pain. It has several positive
effects which makes it highly recommended for targeting the peripheral
compartment in addition to central sites of action.
Neuropathic pain
(NP) has several therapeutic options but efficacy is limited and adverse effects
occur, such that additional treatment options are needed. A topical formulation
containing amitriptyline 4% and ketamine 2% (AmiKet) may provide such an
option.
This report
summarizes both published and unpublished results of clinical trials with
cmiKet produces a significant
analgesia which is comparable to that produced by oral gabapentin. In diabetic
painful neuropathy, AmiKet showed a strong trend towards pain reduction. In
mixed neuropathic pain, case series reports suggest a favorable response rate,
but are limited by trial characteristics. AmiKet is absorbed minimally
following topical administration. Over 700 patients have now received topical
AmiKet in clinical regimens, and it is well-tolerated with the adverse effects
mainly being application site reactions. Both agents are polymodal, and several
mechanisms may contribute to the peripheral efficacy of AmiKet.
Topical AmiKet
has the potential to be a first-line treatment option for PHN, and to be useful
in other NP conditions.
Furthermore,
AmiKet has the potential to be an adjunct to systemic therapies, with the
targeting of a peripheral compartment in addition to central sites of action
representing a rational drug combination.
Expert Opin Pharmacother. 2016 Mar; 17(4): 601-9
Topical amitriptyline and ketamine for post-herpetic neuralgia and other forms of neuropathic pain
Jana Sawynok
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