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Dextromethorphan Versus Placebo for Neuropathic Pain

Primary Purpose

Diabetic Neuropathies, Herpes Zoster, Neuralgia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
dextromethorphan
Sponsored by
National Institute of Dental and Craniofacial Research (NIDCR)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Neuropathies focused on measuring Diabetes Mellitus, Diabetic Neuropathy, Memantine, NMDA Receptor Antagonists, Neuropathic Pain, Neuropathy, Post-Herpetic Neuralgia, Shingles

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Patients must be over 18 years of age. Patients must have a definite diagnosis of diabetic neuropathy or post herpetic neuralgia or a diagnosis of neuropathic pain of various etiologies other than diabetic neuropathy or post herpetic neuralgia. Duration of symptoms must be at least 3 months. Severity of pain must be at least mild, if constant; or at least moderate, if intermittent and at least 2 hours duration a day. Patients using tricyclics, narcotics, or antiseizure medications, must keep the drug dosages constant throughout the study. No patients with unstable disease process; i.e., angina pectoris, accelerated hypertension, recent stroke or transient cerebral ischemia, uncontrolled seizures. No pregnant or lactating women. Women of child bearing potential must use birth control pills, intrauterine device, or barrier contraceptive devices. No history of significant drug abuse or PCP use. No history of IV drug abuse, prescription drug abuse, or alcoholism. No significant liver or kidney disease. No MAO inhibitors. No cognitive impairment or language difficulty as judged by difficulty completing pain diary, medical history, or telephone conversation. Patients must not have any other chronic pain condition that gives them pain greater than the neuropathy pain.

Sites / Locations

  • National Institute of Dental And Craniofacial Research (NIDCR)

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 3, 1999
Last Updated
March 3, 2008
Sponsor
National Institute of Dental and Craniofacial Research (NIDCR)
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1. Study Identification

Unique Protocol Identification Number
NCT00001344
Brief Title
Dextromethorphan Versus Placebo for Neuropathic Pain
Official Title
Dextromethorphan Versus Placebo for Neuropathic Pain
Study Type
Interventional

2. Study Status

Record Verification Date
March 2000
Overall Recruitment Status
Completed
Study Start Date
March 1993 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
February 2001 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
National Institute of Dental and Craniofacial Research (NIDCR)

4. Oversight

5. Study Description

Brief Summary
In our current clinical trial, we are comparing the effects of two NMDA receptor antagonists to placebo in patients with painful distal symmetrical diabetic neuropathy or post-herpetic neuralgia. The treatments in this three-period crossover study are dextromethorphan, up to 920 mg/day (about 8 times the antitussive dose), memantine, 30-50 mg/day, and placebo. Memantine is an NMDA antagonist used in Europe to treat Parkinson's disease and Alzheimer's disease. The underlying hypothesis, based on studies of painful neuropathies in animal models, is that neuropathic pain is caused largely by sensitization of central nervous system neurons caused by excitatory amino acid neurotransmitters, acting largely through NMDA receptors. A previous small trial of dextromethorphan suggested efficacy in diabetic neuropathy pain. The study requires one visit to the NIH outpatient Pain Research Clinic, and consists of three 9-week treatment periods. Patients who respond to one of the medications will be invited to participate in further controlled studies of the medication followed by up to several years of open-label treatment under continued observation.
Detailed Description
In our current clinical trial, we are comparing the effects of two NMDA receptor antagonists to placebo in patients with painful distal symmetrical diabetic neuropathy or post-herpetic neuralgia. The treatments in this three-period crossover study are dextromethorphan, up to 920 mg/day (about 8 times the antitussive dose), memantine, 30-50 mg/day, and placebo. Memantine is an NMDA antagonist used in Europe to treat Parkinson's disease and Alzheimer's disease. The underlying hypothesis, based on studies of painful neuropathies in animal models, is that neuropathic pain is caused largely by sensitization of central nervous system neurons caused by excitatory amino acid neurotransmitters, acting largely through NMDA receptors. A previous small trial of dextromethorphan suggested efficacy in diabetic neuropathy pain. The study requires one visit to the NIH outpatient Pain Research Clinic, and consists of three 9-week treatment periods. Patients who respond to one of the medications will be invited to participate in further controlled studies of the medication followed by up to several years of open-label treatment under continued observation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Neuropathies, Herpes Zoster, Neuralgia
Keywords
Diabetes Mellitus, Diabetic Neuropathy, Memantine, NMDA Receptor Antagonists, Neuropathic Pain, Neuropathy, Post-Herpetic Neuralgia, Shingles

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Enrollment
129 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
dextromethorphan

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Patients must be over 18 years of age. Patients must have a definite diagnosis of diabetic neuropathy or post herpetic neuralgia or a diagnosis of neuropathic pain of various etiologies other than diabetic neuropathy or post herpetic neuralgia. Duration of symptoms must be at least 3 months. Severity of pain must be at least mild, if constant; or at least moderate, if intermittent and at least 2 hours duration a day. Patients using tricyclics, narcotics, or antiseizure medications, must keep the drug dosages constant throughout the study. No patients with unstable disease process; i.e., angina pectoris, accelerated hypertension, recent stroke or transient cerebral ischemia, uncontrolled seizures. No pregnant or lactating women. Women of child bearing potential must use birth control pills, intrauterine device, or barrier contraceptive devices. No history of significant drug abuse or PCP use. No history of IV drug abuse, prescription drug abuse, or alcoholism. No significant liver or kidney disease. No MAO inhibitors. No cognitive impairment or language difficulty as judged by difficulty completing pain diary, medical history, or telephone conversation. Patients must not have any other chronic pain condition that gives them pain greater than the neuropathy pain.
Facility Information:
Facility Name
National Institute of Dental And Craniofacial Research (NIDCR)
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
1866755
Citation
Albers GW, Saenz RE, Moses JA Jr, Choi DW. Safety and tolerance of oral dextromethorphan in patients at risk for brain ischemia. Stroke. 1991 Aug;22(8):1075-7. doi: 10.1161/01.str.22.8.1075.
Results Reference
background
PubMed Identifier
1967971
Citation
Bakshi R, Faden AI. Competitive and non-competitive NMDA antagonists limit dynorphin A-induced rat hindlimb paralysis. Brain Res. 1990 Jan 15;507(1):1-5. doi: 10.1016/0006-8993(90)90512-a.
Results Reference
background
PubMed Identifier
2881608
Citation
Choi DW. Dextrorphan and dextromethorphan attenuate glutamate neurotoxicity. Brain Res. 1987 Feb 17;403(2):333-6. doi: 10.1016/0006-8993(87)90070-9.
Results Reference
background

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Dextromethorphan Versus Placebo for Neuropathic Pain

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