Multiple sclerosis-induced neuropathic pain

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dc.contributor.authorTurcotte, Dana
dc.contributor.examiningcommitteeVercaigne, Lavern (Pharmacy) Ariano, Rob (Pharmacology and Therapeutics) Doupe, Malcolm (Community Health Sciences) Antel, Jack (McGill University)en_US
dc.contributor.supervisorNamaka, Mike (Pharmacy)en_US
dc.date.accessioned2014-02-25T15:53:13Z
dc.date.available2014-02-25T15:53:13Z
dc.date.issued2008en_US
dc.date.issued2004en_US
dc.date.issued2009en_US
dc.date.issued2010en_US
dc.degree.disciplinePharmacyen_US
dc.degree.levelDoctor of Philosophy (Ph.D.)en_US
dc.description.abstractNeuropathic pain (NPP) is a chronic syndrome suffered by patients with multiple sclerosis (MS), for which there is no cure. Underlying cellular mechanisms involved in its pathogenesis are multifaceted, resulting in significant challenges in its management. In addition to its complex pathophysiology, the clinical management of MS-induced NPP is further complicated by the lack of clinical therapeutics trials specific to this population. The primary aim of the work underlying this thesis was to contribute to the evidence-based management of individuals with MS-induced NPP through the completion of two clinical therapeutics trials in this population. A secondary aim was to describe pain variability in this patient population through the development and validation of a pain variability algorithm tool. Resulting from this work, we demonstrated that nabilone – a synthetic oral cannabinoid – represents an effective, well-tolerated and novel treatment for MS-induced NPP. Additionally, we show that the SSRI paroxetine was poorly tolerated in our patient population, with a correspondingly high attrition rate. As a result, we were unable to determine any treatment effect in this trial due to insufficient recruitment due to drop-out. Lastly, we were able to define and describe pain instability in this cohort, noting that approximately 30% of individuals with MS-induced NPP experiencing highly variable daily pain. The results of these projects provide novel information for this patient population. Patients currently living with the daily burden of MS-induced NPP would benefit from additional trials ensuing from this, and other, research in order to initiate a momentum for much-needed clinical research in this complicated patient cohort.en_US
dc.description.noteMay 2014en_US
dc.identifier.citationamaka M, Turcotte D, Leong C, Grossberndt A, et al. (2008). Multiple sclerosis: etiology and treatment strategies. Consultant Pharmacist 23(11):886-96.en_US
dc.identifier.citationNamaka, M.P., Gramlich, C., Ruhlen, D., Major, J., Sutton, I., Melanson, M. A treatment algorithm for neuropathic pain. Clin Ther. 2004; 26(7): 951-979en_US
dc.identifier.citationNamaka, M.P., Leong, C., Grossberndt, A., Klowak, M., Turcotte, D., Esfahani, F., Gomori, A., Intrater, H. Clinical Review: A treatment algorithm for neuropathic pain: An update. The Consultant Pharmacist., 2009; 24(12):885-902en_US
dc.identifier.citationTurcotte, D., Le Dorze, J.A., Esfahani, F., Frost, E., Gomori, A., Namaka, M. Examining the roles of cannabinoids in pain and other therapeutic indications: a review. Expert Opin Pharmacother., 2010 Jan; 11(1):17-31en_US
dc.identifier.urihttp://hdl.handle.net/1993/23316
dc.language.isoengen_US
dc.publisherThe Consultant Pharmacisten_US
dc.publisherClinical Therapeuticsen_US
dc.publisherThe Consultant Pharmacisten_US
dc.publisherExpert Opinion in Pharmacotherapyen_US
dc.rightsopen accessen_US
dc.subjectMultiple Sclerosisen_US
dc.subjectNeuropathic Painen_US
dc.subjectcannabinoidsen_US
dc.subjectnabiloneen_US
dc.subjectparoxetineen_US
dc.subjectpregabalinen_US
dc.subjectclinical trialen_US
dc.titleMultiple sclerosis-induced neuropathic painen_US
dc.typedoctoral thesisen_US
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