Treatment of neuropathic pain with venlafaxine.
OBJECTIVE
To report a case of successful treatment of neuropathic pain with venlafaxine.


METHODS
A 39-year-old white woman presented with neuropathic back pain. The patient obtained 50% pain relief with consecutive use of amitriptyline, desipramine, and imipramine. Anticholinergic effects prompted a switch to extended-release venlafaxine 75 mg/d. Pain relief was as effective with this therapy as with the tricyclic antidepressants. The absence of adverse effects allowed the patient to discontinue all laxatives.


CONCLUSIONS
Venlafaxine is an antidepressant that inhibits reuptake of norepinephrine and serotonin. This is the major mechanism by which tricyclic antidepressants relieve neuropathic pain. Venlafaxine does not bind to muscarinic-cholinergic, histaminic or alpha1-adrenergic receptors responsible for the common adverse effects seen with tricyclic antidepressants.


CONCLUSIONS
This report describes the efficacious use of venlafaxine in the treatment of neuropathic pain. Double-blind, randomized, controlled trials are needed to explore this further.
Sumpton
J E
JE
Pharmacy Department, London Health Sciences Centre, Ontario, Canada. janice.sumpton@lhsc.on.ca
Moulin
D E
DE
D000328:Adult; D003511:Cyclohexanols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride