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Cited by 93Pain Mechanisms and TreatmentsPain Management and TreatmentPain Management and Opioid Use

Topical Amitriptyline Versus Lidocaine in the Treatment of Neuropathic Pain

Ho, Kok-Yuen, Huh, Billy K., White, William D., Yeh, Chun-Chang, Miller, Eric J.·2008·The Clinical Journal of Pain
DOI 10.1097/ajp.0b013e318156db26
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Abstract

OBJECTIVE: Oral amitriptyline, a tricyclic antidepressant, is effective for treating neuropathic pain. We conducted a double-blind, randomized, placebo-controlled crossover study to evaluate the efficacy of topical 5% amitriptyline and 5% lidocaine in treating patients with neuropathic pain. METHODS: Thirty-five patients with postsurgical neuropathic pain, postherpetic neuralgia, or diabetic neuropathy with allodynia or hyperalgesia were assigned to receive 3 topical creams (5% amitriptyline, 5% lidocaine, or placebo) in random sequence. The primary outcome measure was change in pain intensity (baseline vs. posttreatment average pain) using a 0 to 100 mm Visual Analog Scale. Secondary outcome measures included the McGill Pain Questionnaire, requirement for rescue medication, and patient satisfaction. Primary statistical comparisons were made with paired t tests or signed-rank tests. RESULTS: A reduction in pain intensity was observed with topical lidocaine (P<0.05). No significant change in pain intensity was found with topical amitriptyline or placebo. In pairwise comparison of treatments, topical lidocaine and placebo each reduced pain more than topical amitriptyline (P<0.05). DISCUSSION: This randomized, placebo-controlled crossover study examining topical 5% amitriptyline and 5% lidocaine in the treatment of neuropathic pain showed that topical lidocaine reduced pain intensity but the clinical improvement is minimal and that topical 5% amitriptyline was not effective.

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Crossref · 10.1097/ajp.0b013e318156db26

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31 of 31 references verified0 citation errors · 0 not checkable

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  • A topical 5% amitriptyline cream was not found to be effective compared with 5% lidocaine cream or a placebo.

    “A topical 5% amitriptyline cream has also been tried, but it was not found to be effective compared with 5% lidocaine cream or a placebo [58].”

    From Chronic postsurgical pain: current evidence for prevention and management (2018) · cites this paper as [58]

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Authors
Ho, K.-Y., Huh, B. K., White, W. D., Yeh, C.-C., & Miller, E. J.
Affiliations
  • Singapore General Hospital (SG)
  • Duke University (US)
  • Tri-Service General Hospital (TW)
Corresponding author
Ho, Kok-Yuen
ORCID
Venue
The Clinical Journal of Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2008-01
Volume
24
Issue
1
Pages
51-55
ISSN
0749-8047 (ISSN-L)
DOI
10.1097/ajp.0b013e318156db26
OpenAlex
W2014952936
Cited by
93
References
31
Citations by year
2026: 2 · 2025: 5 · 2024: 2 · 2023: 5 · 2021: 6 · 2020: 6 · 2019: 5 · 2018: 2 · 2017: 8 · 2016: 5 · 2015: 9 · 2014: 6 · 2013: 4 · 2012: 8
FWCI
4.29
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Journal of Pain (publishedVersion)
  • PubMed (publishedVersion)
Funders
McGill University
Topics
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
neuropathic pain, lidocaine, postoperative pain, postherpetic neuralgia, diabetic neuropathy, allodynia, hyperalgesia, pain intensity, tricyclic antidepressants, topical analgesics
MeSH terms
Administration, Topical, Amitriptyline, Anesthetics, Local, Double-Blind Method, Female, Humans, Lidocaine, Male, Middle Aged, Pain, Pain Measurement, Peripheral Nervous System Diseases, Prospective Studies, Surveys and Questionnaires, Treatment Outcome, Sample Size, Analgesics, Non-Narcotic

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