[Pharmacological treatment of neuropathic pain in primary care].
Neuropathic pain is difficult to treat. First line treatment includes tricyclic antidepressants (notably amitriptyline), mixed serotonin and norepinephrine reuptake inhibitors (duloxetine for diabetic peripheral neuropathic pain), antiepileptics (gabapentin and pregabalin) and topical agents (lidocaine plasters for postherpetic neuralgia). These drugs can be subsequently associated in case of partial response to monotherapy. Opioids and tramadol are only considered second/third line, alone or in combination with first line drugs.
Inserm U987, centre d'évaluation et de traitement de la douleur, hôpital Ambroise-Paré, AP-HP, 92100 Boulogne-Billancourt, France. nadine.attal@apr.aphp.fr
Nadine
N
Attal
D017668:Age of Onset; D000465:Algorithms; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D006801:Humans; D009437:Neuralgia / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods*
D000929:Antidepressive Agents, Tricyclic