Treatment considerations in neuropathic pain

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Curr Treat Options Neurol. 2006 Sep;8(5):389-400.

Treatment considerations in neuropathic pain.

Leo RJ.

Department of Psychiatry, School of Medicine and Biomedical Sciences,

State University of New York at Buffalo, Erie County Medical Center,

462 Grider Street, Buffalo, NY 14215, USA.

Neuropathy is a relatively common source of acute and chronic pain.

Emerging evidence suggests several pathophysiological mechanisms

underlying the neuropathic pain associated with various disorders.

Antidepressants and anticonvulsants have largely been the mainstay of

treatment.

Pharmacologic treatment of neuropathy frequently requires use of

multiple medications. Ideally, the selection of which medications to

use should be based on targeting the multiple pathophysiologic

mechanisms contributing to neuropathic pain transmission.

Psychological variables may play a role in predisposing patients to

chronic neuropathy after acute illness. In addition, comorbid

conditions, especially depression, can complicate the presentation,

clinical course, and response to treatment of patients with chronic

pain. Treatment of depression may be essential to fully enlist the

chronic neuropathic pain patient in comprehensive pain management and

rehabilitative approaches.