Sodium creams and sprays for neuropathic pain
Sodium creams and sprays are promising in the treatment of neuropathic pain. An Indian research group starts stating that combination of drugs with different mechanisms of action, helps in achieving synergistic analgesic effect in neuropathic pain. This is also our experience.
They designed a prospective double-blind randomized placebo-controlled study in 87 diabetics type 2 with painful neuropathy. Of which
- 83 were given either sodium valproate and GTN spray (group A), or
- placebo drug and GTN spray (group B), or
- sodium valproate and placebo spray (group C), or
- placebo drug and placebo spray (group D).
- All the 3 treatment groups experienced significant improvement in pain score in their drug phase of trial (p<0.001/<0.05). The assessment of the magnitude of therapeutic effect of sodium valproate, GTN and their combination gave numbers needed to treat (NNT) of 7, 5 and 4, respectively.
The conclusion was that Sodium valproate and GTN are well tolerated and provide significant improvement in pain scores. As well as in electro-physiological parameters.
This is in line with our own experience with our ORES 1 and 2 creams, using Capsaicine, Lidocaine and isosorbide dinitrate. Transdermal applications need more attention and can help patients suffering from neuropathic pain.
Sodium channel blockers for neuropathic pain
Other related news: At the European Pain Federation (EFIC) at Copenhagen in 2017, there was a plenary section on the management of refractory neuropathic pain. It was chaired by Dr Andrea Triuni from Italy.
At this section professor Nadine Attal presented an overview. She mentioned the sodium channel blockers as a new class of compounds. With promising effects in specific populations of neuropathic pain patients.
This indeed is also our experience, as we have meanwhile treated in the Netherlands 200 patients suffering from therapy refractory neuropathic pain by phenytoin cream.
Phenytoin is a sodium channel blocker. These results were shared during the discussion and especially interesting was the fact that botulinum injection worked better in patients with intact small fibre density.
February 2010, Jan M. Keppel Hesselink, MD, PhD, 2017
‘Sodium creams and spray for neuropathic pain’
Watch our video’s about Neuropathy.
 Agrawal RP, Goswami J, Jain S, Kochar DK. | Management of diabetic neuropathy by sodium valproate and glyceryl trinitrate spray: a prospective double-blind randomized placebo-controlled study. | Diabetes Res Clin Pract. | 2009 Mar;83(3):371-8.
 Kopsky DJ, Keppel Hesselink JM. | A new combination cream for the treatment of severe neuropathic pain. | J Pain Symptom Manage. | 2010 Feb;39(2):e9-e10.