title: Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline.
abstract: OBJECTIVE
  To provide evidence-based guidance on the optimum prevention and treatment approaches in the management of chemotherapy-induced peripheral neuropathies (CIPN) in adult cancer survivors.
  
  
  METHODS
  A systematic literature search identified relevant, randomized controlled trials (RCTs) for the treatment of CIPN. Primary outcomes included incidence and severity of neuropathy as measured by neurophysiologic changes, patient-reported outcomes, and quality of life.
  
  
  RESULTS
  A total of 48 RCTs met eligibility criteria and comprise the evidentiary basis for the recommendations. Trials tended to be small and heterogeneous, many with insufficient sample sizes to detect clinically important differences in outcomes. Primary outcomes varied across the trials, and in most cases, studies were not directly comparable because of different outcomes, measurements, and instruments used at different time points. The strength of the recommendations is based on the quality, amount, and consistency of the evidence and the balance between benefits and harms.
  
  
  CONCLUSIONS
  On the basis of the paucity of high-quality, consistent evidence, there are no agents recommended for the prevention of CIPN. With regard to the treatment of existing CIPN, the best available data support a moderate recommendation for treatment with duloxetine. Although the CIPN trials are inconclusive regarding tricyclic antidepressants (such as nortriptyline), gabapentin, and a compounded topical gel containing baclofen, amitriptyline HCL, and ketamine, these agents may be offered on the basis of data supporting their utility in other neuropathic pain conditions given the limited other CIPN treatment options. Further research on these agents is warranted.
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Christina
authors.initials: C
authors.lastname: Lacchetti
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Dworkin
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Lavoie Smith
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bleeker
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Guido
authors.initials: G
authors.lastname: Cavaletti
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Chauhan
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Patrick
authors.initials: P
authors.lastname: Gavin
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Lavino
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Maryam B
authors.initials: MB
authors.lastname: Lustberg
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Judith
authors.initials: J
authors.lastname: Paice
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Bryan
authors.initials: B
authors.lastname: Schneider
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Smith
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Tom
authors.initials: T
authors.lastname: Smith
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Shelby
authors.initials: S
authors.lastname: Terstriep
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Nina
authors.initials: N
authors.lastname: Wagner-Johnston
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Kate
authors.initials: K
authors.lastname: Bak
authors.affiliation: Dawn Hershman, Columbia University Medical Center, New York; Robert Dworkin, University of Rochester, Rochester, NY; Christina Lacchetti and Kate Bak, American Society of Clinical Oncology, Alexandria, VA; Ellen M. Lavoie Smith, University of Michigan, Ann Arbor; Patrick Gavin, Marne, MI; Jonathan Bleeker, Sanford University of South Dakota Medical Center, Sioux Falls, SD; Guido Cavaletti, University of Milano-Bicocca, Monza, Italy; Cynthia Chauhan, Wichita, KS; Antoinette Lavino, Massachusetts General North Shore Cancer Center, Danvers, MA; Maryam Lustberg, Ohio State University, Columbus, OH; Judith Paice, Northwestern University, Chicago, IL; Bryan Schneider, Indiana University, Indianapolis, IN; Mary Lou Smith, Research Advocacy Network, Plano, TX; Tom Smith, Johns Hopkins, Baltimore, MD; Shelby Terstriep, Sanford Health, Fargo, ND; Nina Wagner-Johnston, Washington University, St Louis, MO; and Charles Loprinzi, Mayo Clinic, Rochester, MN.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
mesh_terms: D000328:Adult; D000588:Amines / Q000627:therapeutic use; D000639:Amitriptyline / Q000008:administration & dosage; D000700:Analgesics / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001418:Baclofen / Q000008:administration & dosage; D015897:Comorbidity; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000068736:Duloxetine Hydrochloride; D019317:Evidence-Based Medicine; D000077206:Gabapentin; D005782:Gels; D006801:Humans; D015994:Incidence; D007649:Ketamine / Q000008:administration & dosage; D009369:Neoplasms / Q000188:drug therapy*; D009437:Neuralgia / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D017741:Survivors; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome; D014481:United States; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D000970:Antineoplastic Agents; D003509:Cyclohexanecarboxylic Acids; D005782:Gels; D013876:Thiophenes; D000639:Amitriptyline; D005680:gamma-Aminobutyric Acid; D007649:Ketamine; D000077206:Gabapentin; D000068736:Duloxetine Hydrochloride; D001418:Baclofen