Mechanistic stratification of antineuralgic agents.
Current treatment options in neuropathic pain include antidepressants, antiepileptics, antiarrhythmics, and analgesics. However, stratification of treatments based on their original therapeutic class is inadequate, as drugs belonging to a particular class may have distinct antineuralgic modes of action. It is therefore useful to review the mechanisms of action of these drugs and determine which of these mechanisms is most likely responsible for the drugs' efficacy in the symptomatic treatment of neuropathic pain. Switching from the traditional therapeutic class stratification to one based on putative antineuralgic mechanisms of action will allow more rational selection of therapies, and aid evaluation of the additive or synergistic effects of drugs when used in combination.
Beydoun
Ahmad
A
Department of Neurology, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
Backonja
Misha-Miroslav
MM
D000700:Analgesics / Q000145:classification* / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D002493:Central Nervous System Diseases / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D009437:Neuralgia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D010525:Peripheral Nerves / Q000187:drug effects / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D011786:Quality Control; D013116:Spinal Cord / Q000187:drug effects / Q000503:physiopathology
D000700:Analgesics; D000779:Anesthetics, Local; D000889:Anti-Arrhythmia Agents; D000927:Anticonvulsants; D000928:Antidepressive Agents