Clinical Neuropharmacology of Pain in Spinal Cord Injury- Dextromethorphan/Lidocaine Combination Clinical Trial

NCT ID: NCT02218203

Last Updated: 2025-12-08

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-04-30

Study Completion Date

2008-01-31

Brief Summary

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This randomized, placebo-controlled, double-blind 4x4 crossover clinical trial was part of a larger NIH-funded study to evaluate the analgesic efficacy of multiple dose-combinations of chronic oral (PO) dextromethorphan and intravenous (IV) lidocaine in central neuropathic pain following spinal cord injury.

Detailed Description

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This trial has several objectives:

Primary Objective To determine which combination (dose-ratio) of dextromethorphan and lidocaine provides the best balance of pain reduction and toxicity.

Secondary Objectives include To evaluate the analgesic efficacy of both dextromethorphan and lidocaine in attenuating pain related to central nervous system sensitization, specifically spontaneous pain, mechanical allodynia, and hyperalgesia.

Conditions

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Central Neuropathic Pain Allodynia Spinal Cord Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Placebo- 0mg/kg Lido

Placebo in combination with 0mg/kg LBM lidocaine

Group Type PLACEBO_COMPARATOR

Placebo (Dextromethorphan)

Intervention Type DRUG

0mg Dextromethorphan

Placebo (Lidocaine)

Intervention Type DRUG

0mg/kg LBM Lidocaine

Placebo - 1mg/kg Lido

Placebo in combination with 1mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Placebo (Dextromethorphan)

Intervention Type DRUG

0mg Dextromethorphan

Placebo - 2mg/kg Lido

Placebo in combination with 2mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Placebo (Dextromethorphan)

Intervention Type DRUG

0mg Dextromethorphan

Placebo - 4mg/kg Lido

Placebo in combination with 4mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Placebo (Dextromethorphan)

Intervention Type DRUG

0mg Dextromethorphan

Low Dose Dex - 0mg/kg Lido

Low dose dextromethorphan in combination with 0mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Placebo (Lidocaine)

Intervention Type DRUG

0mg/kg LBM Lidocaine

Low Dose Dex - 1mg/kg Lido

Low dose dextromethorphan in combination with 1mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Low Dose Dex - 2mg/kg Lido

Low dose dextromethorphan in combination with 2mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Low Dose Dex - 4mg/kg Lido

Low dose dextromethorphan in combination with 4mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Medium Dose Dex - 0mg/kg Lido

Medium dose dextromethorphan in combination with 0mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Placebo (Lidocaine)

Intervention Type DRUG

0mg/kg LBM Lidocaine

Medium Dose Dex - 1mg/kg Lido

Medium dose dextromethorphan in combination with 1mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Medium Dose Dex - 2mg/kg Lido

Medium dose dextromethorphan in combination with 2mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Medium Dose Dex - 4mg/kg Lido

Medium dose dextromethorphan in combination with 4mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

High Dose Dex - 0mg/kg Lido

High dose dextromethorphan in combination with 0mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Placebo (Lidocaine)

Intervention Type DRUG

0mg/kg LBM Lidocaine

High Dose Dex - 1mg/kg Lido

High dose dextromethorphan in combination with 1mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

High Dose Dex - 2mg/kg Lido

High dose dextromethorphan in combination with 2mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

High Dose Dex - 4mg/kg Lido

High dose dextromethorphan in combination with 4mg/kg LBM lidocaine

Group Type EXPERIMENTAL

Dextromethorphan

Intervention Type DRUG

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Lidocaine

Intervention Type DRUG

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Interventions

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Dextromethorphan

Administered in 4 periods (placebo, low dose, medium dose, and high dose) for each subject, relative to each subject's MTD)

Intervention Type DRUG

Lidocaine

0mg, 1mg, 2mg, and 4mg Lidocaine per kg of lean body mass (LBM), during each of the 4 dextromethorphan periods (placebo, low dose, medium dose, and high dose)

Intervention Type DRUG

Placebo (Dextromethorphan)

0mg Dextromethorphan

Intervention Type DRUG

Placebo (Lidocaine)

0mg/kg LBM Lidocaine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Healthy male or female adults, age 18 to 70 with central neuropathic pain for a minimum of 3 months following SCI as confirmed by neurologic evaluation, with an average pain intensity score of at least moderate over at least 50% of the day for the 7 days prior to the screening visit and over the 7 days prior to starting study medication.
2. Subjects used no medication or a stabilized medication regimen for chronic and well-controlled medical conditions
3. Serum laboratory examination obtained at study entry:
4. Normal cognitive function.
5. Signed informed consent.

Exclusion Criteria

1. Pregnancy or breast-feeding.
2. Renal or hepatic dysfunction.
3. Significant cardiac disease (e.g. MI within 1 year).
4. Signs or symptoms of central neurological disorder, excluding SCI.
5. Severe psychological disorder requiring treatment.
6. History of hypersensitivity or intolerance to dextromethorphan or lidocaine.
7. Participation in a study of an investigational drug or device within 30 days prior to screening for this study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role collaborator

Brigham and Women's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Christine N. Sang, MD, MPH

Director, Translational Pain Research

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christine N. Sang, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Translational Pain Research, Brigham and Women's Hospital (Disclosure: Patent)

Locations

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Translational Pain Research, Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Countries

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United States

Related Links

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http://www.paintrials.org

Translational Pain Research, Brigham and Women's Hospital

Other Identifiers

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R01NS041503

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2000p001387

Identifier Type: -

Identifier Source: org_study_id

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