Mood and Quality of Life in Neuropathic Pain Reduction

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Anesth Analg. 2006 May;102(5):1473-9.

The impact of therapy on quality of life and mood in neuropathic

pain: what is the effect of pain reduction?

Deshpande MA, Holden RR, Gilron I.

Department of Anesthesiology, Queen's University, Kingston General

Hospital, Kingston, Ontario, Canada.

Mood and quality of life (QOL) outcomes vary widely in neuropathic

pain trials. This may be a result of variable analgesia and other

treatment effects. We evaluated the relationship between pain

reduction and mood/QOL in neuropathic pain. Pain, side effects, QOL,

and mood from a trial of morphine, gabapentin, and a morphine-

gabapentin combination were examined. Baseline QOL was impaired

according to Short Form Health Survey (SF-36) scores. Baseline mood,

according to Profile of Mood States scores, was comparable to that of

a nondepressed population. Pain reduction with all three active trial

treatments correlated with improved QOL. Pain reduction with morphine

and with gabapentin correlated with improved mood. Pain reduction

with a morphine-gabapentin combination correlated with improvement in

only one of several domains of the Profile of Mood States. Severity

of sedation, constipation, and dry mouth during any treatment did not

correlate with mood/QOL changes. These results can be interpreted to

imply that larger analgesic treatment effect sizes lead to more

substantial improvements in QOL and/or mood. However, other

beneficial or adverse treatment-related side effects may also affect

mood/QOL. Therefore, future studies are needed to also evaluate the

impact of treatment-related side effects on mood/QOL in analgesic

trials.