tapentadol and Phantom-Limb

The successful therapy of phantom pain remains a major challenge, because the underlying pathophysiological mechanisms are still not fully understood. A therapeutic approach with tapentadol has not been described so far.. Five patients suffering upper and lower extremity phantom pain were successfully treated with tapentadol (prolonged release) with differing doses.. In 4 patients, a strongly reduced pain intensity between 4 and 6.5 on the visual analog scale (VAS) was recorded. The fifth patient reported an increase in the nocturnal sleep duration from 2 to 5 h and a decrease in the number of phantom pain attacks by 30 %. In 2 patients, the additional medication could be lowered or stretched. Side effects (vertigo, fatigue) were only observed in one subject.. The cases described provide preliminary evidence that the synergistic combination of μ-opioid receptor agonism (MOR) and noradrenalin re-uptake inhibition (NRI) provided by tapentadol may be beneficial in the treatment of phantom pain.

Topics: Adult; Aged; Aged, 80 and over; Analgesics, Opioid; Delayed-Action Preparations; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Pain Measurement; Phantom Limb; Phenols; Receptors, Opioid, mu; Tapentadol