ABSTRACT
Neuropathic pain is by definition a chronic pain condition that occurs and persists in a heterogeneous group of aetiologically different diseases characterised by a primary lesion or dysfunction of the peripheral or central nervous system. Neuropathic pain has an important prevalence in the general population, and a severe impact on quality of life and mood of affected patients. Therapy is based on tricyclic antidepressants and antiepileptic drugs, the most frequently studied drug classes. Opioids and analgesics are a second-line choice. Topical medications could be useful in several pain situations.
Subject(s)
Anticonvulsants/therapeutic use , Antidepressive Agents/therapeutic use , Nervous System Diseases/drug therapy , Pain/drug therapy , Administration, Topical , Analgesics/therapeutic use , Humans , Narcotics/pharmacology , Nervous System Diseases/epidemiology , Nervous System Diseases/physiopathology , Pain/epidemiology , Pain/physiopathologyABSTRACT
Antidepressants are included in evidence-based guidelines for the prophylactic therapy of migraine. Although they can cause several side effects depending on the neurochemical activity, and are to be used with caution in older patients, some of them have a well-documented efficacy. Amitriptyline is classified as a Group 1 drug, whereas Fluoxetine is included in Group 2. There is fair support for the effectiveness of other serotonine reuptake inhibitors in migraine prevention. Amitriptyline has demonstrated a consistent efficacy in Chronic Tension Type Headache, and Mirtazapine has a promising profile for the treatment of the same disease.
Subject(s)
Antidepressive Agents/therapeutic use , Headache/drug therapy , Antidepressive Agents/pharmacology , Antidepressive Agents, Tricyclic/therapeutic use , Chronic Disease , Clinical Trials as Topic , Humans , Migraine Disorders/prevention & control , Selective Serotonin Reuptake Inhibitors/therapeutic useABSTRACT
Neuropathic cranial pain, i.e. pain due to central or peripheral nervous system damage localized in cranial area, is a clinical challenge for the neurologist. Despite major advances in knowledge of physiology and biochemistry of pain, relief for many patients suffering from neuropathic pain remains incomplete. Adjuvant analgesics play a key role in the management of neuropathic pain. The introduction in the therapeutical armamentarium of antiepileptic drugs and the results derived from clinical studies indicate that some of these compounds show promise in the treatment of neuropathic pain.
