Spinal Cord Injuries Medication

Updated: Nov 01, 2018
  • Author: Lawrence S Chin, MD, FACS, FAANS; Chief Editor: Brian H Kopell, MD  more...
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Medication

Medication Summary

The goal of pharmacotherapy is to improve motor function and sensation in patients with spinal cord injuries (SCIs).

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Glucocorticoids

Class Summary

Glucocorticoids are high-dose steroids, which are thought to reduce the secondary effects of acute spinal cord injury (SCI). Studies have shown limited but significant improvement in the neurologic outcome of patients treated within 8 hours of injury.

Methylprednisolone (Solu-Medrol, A-Methapred, Depo-Medrol, Medrol)

Methylprednisolone is used to reduce the secondary effects of acute spinal cord injury (SCI).

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Analgesics, Other

Class Summary

Various drugs are used for neuropathic pain. GABA analogs have been shown to be effective in treating neuropathic pain in spinal cord injuries. In June 2012, the FDA approved the use of pregabalin for the management of neuropathic pain associated with spinal cord injury. Approval was based on results of 2 randomized, double-blind phase 3 trials comparing flexibly dosed pregabalin (150-600 mg/d) with placebo in 357 patients. Studies showed pregabalin significantly reduced neuropathic pain between baseline and at 12 and 16 weeks in each study, respectively, compared with placebo. More patients taking pregabalin showed 30% and 50% reductions in pain than those taking placebo. [59, 60]

Pregabalin (Lyrica)

Indicated for neuropathic pain associated with spinal cord injury. The precise mechanism of action is unknown but is a GABA analog which binds to a subunit of voltage-gated calcium channels in CNS. It does not affect sodium channels, opiate receptors or cyclooxygenase enzyme activity. Its interactions with descending noradrenergic and serotonergic pathways originating from the brainstem appear to reduce neuropathic pain transmission from the spinal cord.

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