title: Recommendations for the pharmacological management of neuropathic pain: an overview and literature update.
abstract: The Neuropathic Pain Special Interest Group of the International Association for the Study of Pain recently sponsored the development of evidence-based guidelines for the pharmacological treatment of neuropathic pain. Tricyclic antidepressants, dual reuptake inhibitors of serotonin and norepinephrine, calcium channel alpha(2)-delta ligands (ie, gabapentin and pregabalin), and topical lidocaine were recommended as first-line treatment options on the basis of the results of randomized clinical trials. Opioid analgesics and tramadol were recommended as second-line treatments that can be considered for first-line use in certain clinical circumstances. Results of several recent clinical trials have become available since the development of these guidelines. These studies have examined botulinum toxin, high-concentration capsaicin patch, lacosamide, selective serotonin reuptake inhibitors, and combination therapies in various neuropathic pain conditions. The increasing number of negative clinical trials of pharmacological treatments for neuropathic pain and ambiguities in the interpretation of these negative trials must also be considered in developing treatment guidelines. The objectives of the current article are to review the Neuropathic Pain Special Interest Group guidelines for the pharmacological management of neuropathic pain and to provide a brief overview of these recent studies.
authors.affiliation: Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, NY 14642, USA. robert_dworkin@urmc.rochester.edu
authors.forename: Robert H
authors.initials: RH
authors.lastname: Dworkin
authors.forename: Alec B
authors.initials: AB
authors.lastname: O'Connor
authors.forename: Joseph
authors.initials: J
authors.lastname: Audette
authors.forename: Ralf
authors.initials: R
authors.lastname: Baron
authors.forename: Geoffrey K
authors.initials: GK
authors.lastname: Gourlay
authors.forename: Maija L
authors.initials: ML
authors.lastname: Haanpää
authors.forename: Joel L
authors.initials: JL
authors.lastname: Kent
authors.forename: Elliot J
authors.initials: EJ
authors.lastname: Krane
authors.forename: Alyssa A
authors.initials: AA
authors.lastname: Lebel
authors.forename: Robert M
authors.initials: RM
authors.lastname: Levy
authors.forename: Sean C
authors.initials: SC
authors.lastname: Mackey
authors.forename: John
authors.initials: J
authors.lastname: Mayer
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
authors.forename: Srinivasa N
authors.initials: SN
authors.lastname: Raja
authors.forename: Andrew S C
authors.initials: AS
authors.lastname: Rice
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Schmader
authors.forename: Brett
authors.initials: B
authors.lastname: Stacey
authors.forename: Steven
authors.initials: S
authors.lastname: Stanos
authors.forename: Rolf-Detlef
authors.initials: RD
authors.lastname: Treede
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Turk
authors.forename: Gary A
authors.initials: GA
authors.lastname: Walco
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Wells
mesh_terms: D000081:Acetamides / Q000627:therapeutic use; D000588:Amines / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D000077206:Gabapentin; D006801:Humans; D000078334:Lacosamide; D009437:Neuralgia / Q000188:drug therapy* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D000069583:Pregabalin; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000081:Acetamides; D000588:Amines; D000700:Analgesics; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000928:Antidepressive Agents; D003509:Cyclohexanecarboxylic Acids; D000077206:Gabapentin; D000078334:Lacosamide; D000069583:Pregabalin; D017367:Selective Serotonin Reuptake Inhibitors; D005680:gamma-Aminobutyric Acid