Ziconotide is a promising new medication for treating pain after spinal cord injury

Spinal cord injury (SCI) is a serious, irreversible condition that often causes paralysis, disability, and other long-term complications, such as neuropathic pain. Current estimates suggest that 40 to 96 percent of people who sustain SCI will experience chronic pain as a result of their injuries, and up to half of patients experience pain so severe as to disrupt daily activities. Unfortunately, clinicians struggle to treat SCI-related pain, and most existing medications or surgical procedures do not reliably or effectively reduce pain in SCI patients. Health care providers are highly motivated to develop novel treatments to manage neuropathic pain and improve quality of life for individuals with SCI.

Recent studies have identified ziconotide as a promising medication for treating chronic severe pain. Critically, research suggests that ziconotide lacks the addictive properties associated with opioids, potentially offering a safe, non-addictive alternative to opioid pain medications. To test the effectiveness of ziconotide in SCI patients, a team of researchers in France administered the medication to 20 individuals over the course of four years. More than half of these patients reported a reduction in pain levels after receiving the medication, and nearly half of patients experienced significant long-term pain reduction after receiving the medication routinely through an internally placed device. Although three patients who received the internal pump experienced minor surgical complications, ziconotide itself was not associated with long-term side effects or complications.

Chronic pain significantly reduces an individual’s quality of life, but most treatment options are ineffective or unsafe for long-term use. Fortunately, ziconotide may be a promising new medication to safely and effectively manage severe chronic pain in SCI patients. Going forward, further research is necessary to develop optimal pain treatment interventions using ziconotide.

Brinzeu A, Berthiller J, Caillet JB, et al. Ziconotide for spinal cord injury-related pain. European Journal of Pain. (October 2019).

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