title: New approaches to treating pain.
abstract: Pain is the most common reason for patients seeking medical care resulting in an estimated world market for analgesics of more than USD 50 billion. Pain is a highly complex, heterogeneous and dynamic process characterized by specific patterns of phenotypic sensory neuronal change. Current treatment options for pain include opioids and non-opioid analgesics, acetaminophen and non-steroidal anti-inflammatory drugs and other drug classes such as antidepressants and anticonvulsants and a combination thereof. Novel approaches are focusing on the optimization of side-effect profiles of opioid based analgesics, the improvement of selectivity for specific opioid receptors, or by addressing molecular gateways implicated in pain. Promising candidates in development target various types of voltage-gated ion channels and receptors for capsaicin and analogs. Currently, after decades of pain research it has to be stated that the assessment, prevention and treatment of pain in industrialized countries as well as in low-income and middle-income countries are neither adequate nor equitable. Further research is needed so that specifically chronic pain control can be improved and individualized.
authors.affiliation: RD&C Research, Development & Consulting GmbH, Währinger Straße 61, A-1090 Vienna, Austria.
authors.forename: Andrea
authors.initials: A
authors.lastname: Wolkerstorfer
authors.affiliation: RD&C Research, Development & Consulting GmbH, Währinger Straße 61, A-1090 Vienna, Austria.
authors.forename: Norbert
authors.initials: N
authors.lastname: Handler
authors.affiliation: RD&C Research, Development & Consulting GmbH, Ludwigsallee 21, D-52062 Aachen, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Buschmann
mesh_terms: D000700:Analgesics / Q000737:chemistry / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000737:chemistry / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000737:chemistry / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000737:chemistry / Q000627:therapeutic use; D002186:Cannabinoids / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D026941:Sodium Channel Blockers / Q000737:chemistry / Q000627:therapeutic use; D050051:Transient Receptor Potential Channels / Q000737:chemistry / Q000378:metabolism
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000928:Antidepressive Agents; D002121:Calcium Channel Blockers; D002186:Cannabinoids; D026941:Sodium Channel Blockers; D050051:Transient Receptor Potential Channels
keywords: Analgesics; NSAIDs; Non-opioids; Opioids; Pain