{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:16:01Z","timestamp":1789150561841,"version":"build-2803163510"},"reference-count":79,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To establish the efficacy of medications, incidence of adverse events (AEs), and withdrawal rates associated with the pharmacological management of chronic spinal cord injury pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methodology<\/jats:title>\n                  <jats:p>PubMed, MEDLINE, Embase, CINAHL, Web of Science, CENTRAL, and PsycINFO were searched (November 2017) and updated (January 2020). Two independent review authors screened and identified papers for inclusion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-one studies met inclusion requirements for efficacy analysis and 17 for AE and withdrawal rate analysis; no additional papers were included from the updated 2020 search. Treatments were divided into six categories: anticonvulsants (n\u2009=\u20096), antidepressants (n\u2009=\u20093), analgesics (n\u2009=\u20098), anti-spasticity medications (n\u2009=\u20092), cannabinoids (n\u2009=\u20091), and other (n\u2009=\u20092). Trials of anticonvulsants, antidepressants, and cannabinoids included long-term follow-up trials (2\u2009weeks to 4\u2009months), and trials of analgesics and anti-spasticity medications, among others, were short-term trials (0\u20132\u2009days). Effectiveness for neuropathic pain was found for pregabalin (3\/3 studies) and lidocaine (2\/3 studies). Studies using ketamine also reported effectiveness (2\/2), but the quality of these papers was rated as poor. The most frequently reported AEs included dizziness, dry mouth, nausea, and constipation. Pregabalin was associated with a higher risk of somnolence (risk ratio [RR] 3.15, 95% confidence interval [CI]: 2.00\u20134.98) and dizziness (RR 2.9, 95% CI: 1.58\u20135.30). Ketamine was associated with a higher risk of reduced vision (RR 9.00, 95% CI: 0.05\u2013146.11), dizziness (RR 8.33, 95% CI: 1.73\u201340.10), and somnolence (RR 7.00, 95% CI: 1.73\u201340.1). Withdrawal rates ranged from 18.4% for antidepressants to 0\u201330% for anticonvulsants, 0\u201310% for anti-spasticity medications, 0\u201348% for analgesics, 28.6% for cannabinoids, and 0\u201322.2% for other medications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Pregabalin was found to be effective for neuropathic pain vs placebo. Cannabinoids were ineffective for neuropathic pain. AEs are a common cause for withdrawal. The nature of AEs was poorly reported, and AE reporting should be improved in future randomized controlled trials.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnab140","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T12:14:11Z","timestamp":1617970451000},"page":"375-395","source":"Crossref","is-referenced-by-count":13,"title":["The Efficacy, Adverse Events, and Withdrawal Rates of the Pharmacological Management of Chronic Spinal Cord Injury Pain: A Systematic Review and Meta-Analysis"],"prefix":"10.1093","volume":"23","author":[{"given":"Clare","family":"Canavan","sequence":"first","affiliation":[{"name":"UCD Centre for Translational Pain Research"},{"name":"UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield Campus, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-2395","authenticated-orcid":false,"given":"Takayoshi","family":"Inoue","sequence":"additional","affiliation":[{"name":"UCD Centre for Translational Pain Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinead","family":"McMahon","sequence":"additional","affiliation":[{"name":"UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield Campus, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Doody","sequence":"additional","affiliation":[{"name":"UCD Centre for Translational Pain Research"},{"name":"UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield Campus, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Blake","sequence":"additional","affiliation":[{"name":"UCD Centre for Translational Pain Research"},{"name":"UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield Campus, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brona M","family":"Fullen","sequence":"additional","affiliation":[{"name":"UCD Centre for Translational Pain Research"},{"name":"UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield Campus, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"issue":"suppl 1","key":"2022020200234975400_pnab140-B1","doi-asserted-by":"crossref","first-page":"S71","DOI":"10.1016\/j.pain.2012.12.007","article-title":"Pain in patients with spinal cord injury","volume":"154","author":"Finnerup","year":"2013","journal-title":"Pain"},{"issue":"1","key":"2022020200234975400_pnab140-B2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/ejp.522","article-title":"Pain prevalence and its determinants after spinal cord injury: A systematic review","volume":"19","author":"van Gorp","year":"2015","journal-title":"Eur J Pain"},{"issue":"6","key":"2022020200234975400_pnab140-B3","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1038\/sc.2011.156","article-title":"International spinal cord injury pain classification: Part I. 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