peripheral nerve pain research

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Abstract from Pain Med. 2004 Mar;5 Suppl 1:S28-47.

Pharmacologic management part 1: better-studied neuropathic pain

diseases.

Backonja MM, Serra J.

University of Wisconsin Hospital and Clinics, Madison, Wisconsin;

Neuropathic Pain Unit, Hospital General de Catalunya, Barcelona, Spain.

Neuropathic pain impacts millions of people in the United States and

around the world. Patients experience one of many symptoms, such as

pain, paresthesia, dysesthesia, hyperalgesia, and allodynia, for many

years because of unavailable or inadequate treatment. One of the major

challenges in treating patients with neuropathic pain syndromes is a

lack of consensus concerning the appropriate first-line treatment

options for conditions associated with neuropathic pain, including

postherpetic neuralgia, diabetic peripheral neuropathy, and trigeminal

neuralgia. This review summarizes the published results of randomized

trials involving treatment for neuropathic pain conditions.

Anticonvulsants, such as gabapentin, carbamazepine, and lamotrigine, and

tricyclic antidepressants, including amitriptyline and desipramine, have

demonstrated efficacy in relieving pain associated with postherpetic

neuralgia, diabetic peripheral neuropathy, and trigeminal neuralgia, in

several studies. However, the lack of head-to-head comparison studies of

these agents limits the conclusions that can be reached. Clinicians who

must make decisions regarding the care of individual patients may find

some guidance from the number of randomized trials with a positive

outcome for each agent. Using quality-of-life study outcomes, treatment

strategies must encompass the impact of therapeutic agents on the

comorbid conditions of sleep disturbance and mood and anxiety disorders

associated with neuropathic pain. Looking to the future, emerging

therapies, such as pregabalin and newer N-methyl-D-aspartate-receptor

blockers, may provide physicians and patients with new treatment options

for more effective relief of pain.