Update on pharmacotherapy guidelines for treatment of neuropathic pain

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Curr Pain Headache Rep. 2007 Jun;11(3):208-14.

Update on pharmacotherapy guidelines for treatment of neuropathic

pain.

Wallace JM.

E. Whalen VA Medical Center, 500 Foothill Drive, Salt Lake

City, UT 84148, USA.

Neuropathic pain encompasses a myriad of painful disease states that

are often hard to treat, especially with one single medication. In

the comprehensive treatment of neuropathic pain, the concept of

complex polypharmacy is a rational approach, accompanied by physical

and mental health therapies. Medications primarily used for

neuropathic pain generally fall into the categories of

anticonvulsants, antidepressants, opioids, and topical agents.

Generally, most first-line medications used today show a response

rate of approximately 30% to 50% reduction in pain in up to 50% of

patients treated. There is no " gold standard " in regard to one

medication for neuropathic pain.

Some new medications have emerged during the past few years that

help to augment the armamentarium of medications used in neuropathic

pain. This paper reviews the definition of neuropathic pain and

introduces the reader to the evidence-based literature on these new

medications available for the treatment of neuropathic pain.