Abstract
We report three cases which demonstrated the efficacy of oral paroxetine, a selective serotonin reuptake inhibitor (SSRI), in relieving chronic lumbago and lower limb pain.
The first case was a 64-year-old man who fell from a tree, sustaining a comminuted fracture of the first lumbar vertebra (LI) with paresis of both lower extremities. He was treated with anterior spinal fusion using bone grafts obtained from the ilium, and suffered postoperative chronic pain in his right leg and both feet. His chronic pain was alleviated after several caudal blocks were performed and oral paroxetine 10mg day was administered. His pain was further alleviated when paroxetine was increased to 20mg day.
The second case was a 65-year-old man with chronic lumbago and pain of both lower extremities due to L4-L5 and L5-S1 disk herniation and degenerative spondylolisthesis of L5. His chronic pain was not alleviated after epiduroscopy and caudal blocks were performed. Oral paroxetine 10mg/day was administered. His pain was further alleviated when paroxetine was increased to 30mg/day. Erectile impotence occurred as a side effect of paroxetine.
The third case was a 74-year-old man with right lumbar pain and lower limb pain due to lumbar canal stenosis at the level of L4-L5. His chronic pain was alleviated by oral paroxetine 20mg/day. As hypomnesia and amnesia sometimes occurred as a side effect of paroxetine, oral paroxetine was discontinued. However, his severe pain recurred, and oral paroxetine 20mg/day was restarted.
As all cases were old men, we administered paroxetine and did not administer tricyclic antidepressants with side effects of anuresis. These cases suggested the efficacy of paroxetine in relieving chronic lumbago and lower limb pain that are associated with depression dosedependently. Erectile impotence, hypomnesia and amnesia might occur as side effects of paroxetine.
