WESTON, Mass., Sept. 19 /PRNewswire/ -- The recently approved analgesic
ziconotide (Prialt(R), Elan Pharmaceuticals) has been met with enthusiasm by
the pain-management community because of its ability to improve analgesia in
patients with refractory pain unresponsive to opioids. However, a newly
published review reveals that the drug has significant limitations --
including potentially severe adverse effects.
The review appears in the September/October 2005 issue of American Journal
of Hospice & Palliative Medicine.
Eric Prommer, MD, Assistant Professor at the UCLA School of Medicine and a
physician in the Greater Los Angeles VA Healthcare Center's Palliative Care
Program, conducted an exhaustive analysis of the existing research on
ziconotide. His results showed that ziconotide does have significant
analgesic benefits for patients intolerant of other treatments because it
successfully inhibits pain messages to the central nervous system (CNS).
However, he also found significant risks associated with the drug,
especially at higher dose and titration rates. "Ziconotide may produce
analgesia at the potential cost of severe adverse effects," he writes.
Most reported adverse effects are CNS-related, including dizziness,
somnolence, blurred vision, ataxia, involuntary rapid eye movement
(nystagmus), prolonged periods of unresponsiveness, and confusion
(particularly in older patients). Auditory and visual hallucinations and
paranoid ideation have also been reported, occurring most frequently in
patients with a prior psychiatric history. Discontinuation of the drug
resolved the symptoms in all reported cases.
The drug appears to have a "ceiling" related to dose and infusion rates.
Dr. Prommer recommends starting the ziconotide infusion at a low dose (< 0.1
5g/h), with incremental increases no more than once or twice weekly. "[It]
should not be used in lieu of more traditional methods of managing opioid-
resistant pain. How and when it is to be used is yet to be determined," he
concludes.
To order the article, visit the Journal's Web site at
http://www.hospicejournal.com. For additional information, contact the
publisher at American Journal of Hospice & Palliative Medicine, 470 Boston
Post Road, Weston, MA 02493, Tel. 781-899-2702 x142.
Contact:
Richard DeVito, Sr., Publisher
American Journal of Hospice & Palliative Medicine
470 Boston Post Rd.
Weston, MA 02493
Phone: 781-899-2702 x142
http://www.hospicejournal.com
radsr@pnpco.com
SOURCE American Journal of Hospice & Palliative Medicine
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Related links:
http://www.hospicejournal.com
CONTACT:
Richard DeVito, Sr., Publisher of American
Journal of Hospice & Palliative Medicine, +1-781-899-2702 x142,
radsr@pnpco.com
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