Spinal cord stimulation and psychotropic medication use: Missing piece to the puzzle?

Brian Y. Hwang, Serban Negoita, Phan Q. Duy, William S. Anderson

Research output: Contribution to journalArticlepeer-review

Abstract

Psychotropic medications have modulatory effects on spinal cord stimulator (SCS) therapy and may play an important role in determining treatment success in chronic pain management. However, it remains unknown how SCS affects psychotropic use and whether the medications affect outcome. We performed a retrospective study to determine the prevalence of psychotropic medication (i.e. anxiolytic, antidepressant, and anticonvulsant) use among new SCS patients immediately before implantation and characterized the dosage changes at 1-year. We also sought to understand whether pre-operative medication status affects outcome, defined as device explantation due to treatment failure. In an analysis of 45 patients, 31%, 51% and 71% were actively taking anxiolytics, antidepressants, and anticonvulsants, respectively, before surgery. In the majority of cases, daily dosages remained the same for all three classes of medication at 1-year. Patients who were on two or more classes of medications pre-operatively had significantly lower explantation rate compared to those with one or none (12% vs. 43%, p = 0.041) and had 5.25 times less likelihood of explanation in the future (OR 5.25, 95%CI 1.18–23.2, p = 0.029). Our study suggest that peri-operative multimodality medical treatment may enhance the therapeutic efficacy and durability of SCS in carefully selected chronic pain patients.

Original languageEnglish (US)
Pages (from-to)158-160
Number of pages3
JournalJournal of Clinical Neuroscience
Volume81
DOIs
StatePublished - Nov 2020

Keywords

  • Antidepressant
  • Antipsychotic
  • Anxiolytic
  • Chronic pain
  • Spinal cord stimulation

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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