title: Nonopioid medications for pain.
abstract: Evidence of nonopioid analgesic effectiveness exceeds that for long-term opioids in chronic noncancer pain (CNCP), most with lower risk. Non-drug therapies such as cognitive behavioral therapy and physical activation are safer and also effective. Nonsteroidal antiinflammatory drugs are useful for inflammatory and nociceptive pain, share renal and variable gastrointestinal, bleeding and cardiovascular side effects. Antidepressants with noradrenergic activity (such as tricyclics and seroton-norepinephrine reuptake inhibitors) and neuromodulating anticonvulsant drugs (gabapentinoids and sodium-channel blockers) are proven to be effective for neuropathic and centralized pain. Ketamine and cannabinoids are other studied analgesics but have a less well-proven role in CNCP.
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, UW Center for Pain Relief, University of Washington, 1959 Northeast Pacific Street, Box 356540, Seattle, WA 98195, USA; Division of General Internal Medicine, Department of Medicine, UW Center for Pain Relief, University of Washington, 1959 Northeast Pacific Street, Box 356540, Seattle, WA 98195, USA. Electronic address: tauben@uw.edu.
authors.forename: David
authors.initials: D
authors.lastname: Tauben
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D002186:Cannabinoids / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy*; D006801:Humans; D007649:Ketamine / Q000627:therapeutic use; D059408:Pain Management; D010147:Pain Measurement
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D000928:Antidepressive Agents; D002186:Cannabinoids; D007649:Ketamine
keywords: Acetaminophen; Anticonvulsant; Antidepressant; Benzodiazepine; Central sensitization; NSAID; Neuropathic pain; Opioid