Continuing Education in Anaesthesia, Critical Care & Pain | Volume 5 Number 4 2005 © The Board of Management and Trustees of the British Journal of Anaesthesia [2005]. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Pharmacotherapy of neuropathic pain
Pain Management Unit, Royal Berkshire Hospital, London Road, Reading, Berks, RG1 5AN
Tel: 01189 878261/01189 877065, Fax: 01189 878262, E-mail: steve.allen@rbbh-tr.nhs.uk (for correspondence)
| The first 150 words of the full text of this article appear below. |
| Key points The pathophysiology of neuropathic pain is complex. Treatment of neuropathic pain is often poorly understood by healthcare professionals and consequently not managed well. The mainstay of therapy is tricyclic anti-depressants and anti-epileptic drugs. Strong opioids have a role in some patients.
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Neuropathic pain |
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Historically, neuropathic pain (NeP) has proved to be a difficult problem to manage; this has stemmed from a lack of knowledge of the pathophysiology of the disorder, coupled with a deficiency of effective remedies. NeP affects a significant proportion of the population (>500 000 people in the UK) and lack of appropriate treatment can be devastating, both in terms of patient quality of life and economic burden.1
The pathophysiology of NeP is complex and not fully understood.2 It is very different from that of nociceptive or somatic pain where the initial stimulus of the peripheral nociceptor is produced chemically as a result of tissue damage. NeP results
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First-line treatment |
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Pharmacological treatments |
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Antidepressants
Anticonvulsants
Conventional analgesics
Strong opioids
Cannabinoids
Receptor-targeted drugs