Spinal cord stimulation and psychotropic medication use: Missing piece to the puzzle?

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Brian Y HwangWilliam S Anderson

Abstract

Psychotropic medications have modulatory effects on spinal cord stimulator (SCS) therapy and may play an important role in determining treatment success in chronic pain management. However, it remains unknown how SCS affects psychotropic use and whether the medications affect outcome. We performed a retrospective study to determine the prevalence of psychotropic medication (i.e. anxiolytic, antidepressant, and anticonvulsant) use among new SCS patients immediately before implantation and characterized the dosage changes at 1-year. We also sought to understand whether pre-operative medication status affects outcome, defined as device explantation due to treatment failure. In an analysis of 45 patients, 31%, 51% and 71% were actively taking anxiolytics, antidepressants, and anticonvulsants, respectively, before surgery. In the majority of cases, daily dosages remained the same for all three classes of medication at 1-year. Patients who were on two or more classes of medications pre-operatively had significantly lower explantation rate compared to those with one or none (12% vs. 43%, p = 0.041) and had 5.25 times less likelihood of explanation in the future (OR 5.25, 95%CI 1.18-23.2, p = 0.029). Our study suggest that peri-operati...Continue Reading

References

Jun 27, 2007·Psychological Bulletin·Robert J GatchelDennis C Turk
Jul 30, 2009·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·James CelestinRobert N Jamison
Nov 27, 2015·Neuromodulation : Journal of the International Neuromodulation Society·Mohammed F ShamjiDarcia Paul
Feb 23, 2017·Journal of Pain Research·Julie L CunninghamW Michael Hooten
Oct 6, 2017·Neuromodulation : Journal of the International Neuromodulation Society·Dermot P MaherShihab Ahmed
Dec 16, 2017·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Ashwini D SharanDavid A Provenzano
Jan 19, 2019·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Serban NegoitaWilliam S Anderson
Oct 12, 2019·Neuromodulation : Journal of the International Neuromodulation Society·Mark C DoughertyRyan M Carnahan

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