Citation Information :
Nasare NV, Medirattaa PK, Banerjee BD, Deshmukh PS, Saxena AK, Bhattacharya SN, Ahmed RS. Neuropathic pain and sleep disturbances with special reference to patients with postherpetic neuralgia. Indian Sleep Med 2014; 9 (3):119-127.
Objective: The impacts of postherpetic neuralgia (PHN) on patients’ quality of sleep and global perceived effects (GPEs) are poorly documented. Our main aim of the study was to determine the improvement of sleep and GPE after 4 weeks of tramadol (50–200 mg) treatment with rescue analgesia in the form of topical cream containing 3.33% doxepin and 0.05% capsaicin in patients with PHN in relationship with CYP2D6 polymorphism.
Methods: This study mainly comprised 246 patients with PHN including 123 nonresponders and 123 responders undergoing tramadol treatment. The sleep interference was assessed on 0–10 scale using Daily Sleep Interference Scale. The subjects’ overall impression (global evaluation) of the study medication was recorded by subjects’ answering the question. All samples were analyzed for CYP2D6*4 and CYP2D6*10 polymorphism using polymerase chain reaction–restriction fragment length polymorphism method.
Results: Clinically significant (p<0.001) results were obtained in both the groups when compared with baseline between the Numerical Rating Scale (NRS) sleep scores and GPE scores whereas no associations were found between NRS sleep scores and GPE scores when compared with CYP2D6*4 and *10 polymorphisms (p > 0.05).
Conclusions: Treatment with tramadol 50–200 mg/day was found to be significantly associated with reduced sleep interference and improved GPEs of patients with PHN. CYP2D6 (*4 and *10) polymorphisms with respect to NRS sleep and GPE may not be a sleep and GPE predictor for patients with PHN.
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