Central Pain |
Amitriptyline3939. Kim JS. Pharmacological management of central post-stroke pain: a practical guide. CNS Drugs. 2014 Sep;28(9):787-97. https://doi.org/10.1007/s40263-014-0194-y https://doi.org/10.1007/s40263-014-0194-...
|
Start with 25 mg, up to 75 mg |
4 weeks |
Dry mouth, urinary retention, drowsiness, and confusion |
|
Lamotrigine3939. Kim JS. Pharmacological management of central post-stroke pain: a practical guide. CNS Drugs. 2014 Sep;28(9):787-97. https://doi.org/10.1007/s40263-014-0194-y https://doi.org/10.1007/s40263-014-0194-...
|
Start with 25 mg, up to 200 mg |
8 weeks |
Rash and severe headache |
|
Duloxetine4242. Kim NY, Lee SC, Kim YW. Effect of duloxetine for the treatment of chronic central poststroke pain. Clin Neuropharmacol. 2019 May-Jun;42(3):73-6. https://doi.org/10.1097/WNF.0000000000000330 https://doi.org/10.1097/WNF.000000000000...
|
Start with 30 mg, up to 60 mg |
3 weeks |
Nausea, agitation, and drowsiness |
|
Pregabalin4343. Kim JS, Bashford G, Murphy TK, Martin A, Dror V, Cheung R. Safety and Efficacy of pregabalin in patients with central post-stroke pain. Pain. 2011 May;152(5):1018-23. https://doi.org/10.1016/j.pain.2010.12.023 https://doi.org/10.1016/j.pain.2010.12.0...
|
Start with 150 mg, up to 600 mg |
12 weeks |
Somnolence, and peripheral edema |
|
Gabapentin3939. Kim JS. Pharmacological management of central post-stroke pain: a practical guide. CNS Drugs. 2014 Sep;28(9):787-97. https://doi.org/10.1007/s40263-014-0194-y https://doi.org/10.1007/s40263-014-0194-...
|
Start with 900 mg, up to 2400 mg |
8 weeks |
Dizziness and drowsiness |
|
Fluvoxamine4444. Shimodozono M, Kawahira K, Kamishita T, Ogata A, Tohgo S, Tanaka N. Reduction of central poststroke pain with the selective serotonin reuptake inhibitor fluvoxamine. Int J Neurosci. 2002 Oct;112(10):1173-81. https://doi.org/10.1080/00207450290026139 https://doi.org/10.1080/0020745029002613...
|
Start with 50 mg, up to 125 mg |
2 to 4 weeks |
Drowsiness, insomnia, and restlessness |
Mood disorder |
Nortriptyline7979. Robinson RG, Jorge RE. Post-stroke depression: a review. Am J Psychiatry. 2016 Mar 1;173(3):221-31. https://doi.org/10.1176/appi.ajp.2015.15030363 https://doi.org/10.1176/appi.ajp.2015.15...
|
Start with 25 mg, up to 100 mg |
6 weeks |
Dry mouth, urinary retention, drowsiness, and confusion |
|
Trazodone7979. Robinson RG, Jorge RE. Post-stroke depression: a review. Am J Psychiatry. 2016 Mar 1;173(3):221-31. https://doi.org/10.1176/appi.ajp.2015.15030363 https://doi.org/10.1176/appi.ajp.2015.15...
|
Start with 25 mg, up to 200 mg |
32 days |
Dry mouth, urinary retention, drowsiness, and confusion |
|
Citalopram7979. Robinson RG, Jorge RE. Post-stroke depression: a review. Am J Psychiatry. 2016 Mar 1;173(3):221-31. https://doi.org/10.1176/appi.ajp.2015.15030363 https://doi.org/10.1176/appi.ajp.2015.15...
|
Start with 5 mg, up to 10 mg |
6 weeks |
Nausea, drowsiness, weakness, dizziness, anxiety, trouble sleeping, and sexual dysfunction |
|
Fluoxetine7979. Robinson RG, Jorge RE. Post-stroke depression: a review. Am J Psychiatry. 2016 Mar 1;173(3):221-31. https://doi.org/10.1176/appi.ajp.2015.15030363 https://doi.org/10.1176/appi.ajp.2015.15...
|
Start with 10 mg, up to 10 mg |
6 weeks to 3 months |
Nausea headaches, insomnia, diarrhea, weakness, and anxiety |
|
Reboxetine7979. Robinson RG, Jorge RE. Post-stroke depression: a review. Am J Psychiatry. 2016 Mar 1;173(3):221-31. https://doi.org/10.1176/appi.ajp.2015.15030363 https://doi.org/10.1176/appi.ajp.2015.15...
|
4 mg |
16 weeks |
Dry mouth, constipation, and sexual dysfunction |
Sleep disorders |
Trazodone110110. Chen C-Y, Chen C-L, Yu C-C. Trazodone improves obstructive sleep apnea after ischemic stroke: a randomized, double-blind, placebo-controlled, crossover pilot study. Neurol. 2021 Feb 24;268(8):2951-60. https://doi.org/10.1007/s00415-021-10480-2 https://doi.org/10.1007/s00415-021-10480...
|
100 mg |
1 week |
Dry mouth, urinary retention, somnolence, and confusion |
Epilepsy |
Levetiracetam157157. Brigo F, Lattanzi S, Zelano J, Bragazzi NL, Belcastro V, Nardone R, et al. Randomized controlled trials of antiepileptic drugs for the treatment of post-stroke seizures: a systematic review with network meta-analysis. Seizure. 2018 Oct 1;61:P57-62. https://doi.org/10.1016/j.seizure.2018.08.001 https://doi.org/10.1016/j.seizure.2018.0...
|
Start with 500 mg up to 300 mg |
52 weeks |
Fatigue, drowsiness, skin eruptions or allergies |
|
Lamotrigine157157. Brigo F, Lattanzi S, Zelano J, Bragazzi NL, Belcastro V, Nardone R, et al. Randomized controlled trials of antiepileptic drugs for the treatment of post-stroke seizures: a systematic review with network meta-analysis. Seizure. 2018 Oct 1;61:P57-62. https://doi.org/10.1016/j.seizure.2018.08.001 https://doi.org/10.1016/j.seizure.2018.0...
|
Start with 25 mg up to 200 mg |
52 weeks |
Dizziness and rash |
|
Controlled release carbamazepine157157. Brigo F, Lattanzi S, Zelano J, Bragazzi NL, Belcastro V, Nardone R, et al. Randomized controlled trials of antiepileptic drugs for the treatment of post-stroke seizures: a systematic review with network meta-analysis. Seizure. 2018 Oct 1;61:P57-62. https://doi.org/10.1016/j.seizure.2018.08.001 https://doi.org/10.1016/j.seizure.2018.0...
|
Start with 200 mg up to 1600 mg |
52 weeks |
Confusion, skin eruptions or allergies, nausea, and vomiting |