The pharmacological management of neuropathic pain
Journal of the Korean Medical Association
;
: 582-592, 2012.
Article
in Korean
| WPRIM
| ID: wpr-21944
ABSTRACT
Neuropathic pain has recently been defined as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system". Neuropathic pain is a debilitating chronic condition that remains very difficult to treat and challenging to manage. Tricyclic antidepressants (amitryptiline, nortriptyline, imipramine), selective serotonin and norepinephrine reuptake inhibitors (duloxetine, venlafaxine), anticonvulsants (gabapentin, pregabalin), and 5% lidocaine patches have demonstrated efficacy in neuropathic pain and are recommended as first-line medications. In patients who fail to respond to these first-line medications alone and/or in combination, opioid analgesics or tramadol can be used as a second-line treatment alone or in combination with one of the first-line medications. Opioid analgesics and tramadol can also be considered for first-line use in selected clinical circumstances. Other pharmacological therapeutic options include selective serotonin reuptake inhibitors, antiepileptic drugs (levetiracetam, lacosamide, lamotrigine, valproic acid), cannabinoids, high concentration capsaicin patch, and botulinum toxin A. Medication selection should be individualized, with side effects taken into consideration as well as potential beneficial or deleterious effects on comorbidities, and whether or not prompt onset of pain relief is necessary.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Tramadol
/
Triazines
/
Botulinum Toxins
/
Cannabinoids
/
Capsaicin
/
Serotonin
/
Norepinephrine
/
Comorbidity
/
Selective Serotonin Reuptake Inhibitors
/
Analgesics, Opioid
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Medical Association
Year:
2012
Type:
Article
Similar
MEDLINE
...
LILACS
LIS