The study by Agarwal and Joshi1 reports the effectiveness of amitriptyline and lamotrigine in neuropathic pain after traumatic spinal cord injuries. Current available evidence, as demonstrated in a recently published guideline for management of neuropathic pain in spinal cord injury,2 is scarce regarding comparison of two different drugs, as they focus on placebo controlled trials. Amitriptyline was compared to gabapentin and diphenhydramine as an active placebo on a small trial.3 Lamotrigine was only compared to placebo, and demonstrated to be effective in patients with incomplete lesion just after a post hoc analysis.4

Although Agarwal’s trial sums to this body of evidence, the clinical information that can be extracted is uncertain. The Short-form MCGill Pain Questionnaire-2, chosen as a neuropathic pain measurement, has a good interobserver correlation, but until now a minimal clinically important difference has not been established.5

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account
Continue with Google
Continue with ORCiD