Neuropathic pain: treatment

Introduction
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By Yi Pan MD and Florian P Thomas MD PhD

Treatment of neuropathic pain is an ongoing challenge for clinicians. In this clinical summary, Dr. Yi Pan and Dr. Florian P Thomas of St. Louis University summarize pharmacological management based on published clinical trials. Not all medications mentioned in this summary have been investigated in placebo-controlled, double-blind, randomized trials. A new guideline for treating painful diabetic neuropathy was published in 2011. The aim of this summary is to provide a variety of updated information for clinicians to choose an optimal treatment for an individual patient.

Key points

  • Neuropathic pain is frequently treated with antidepressants, anticonvulsants, antiarrhythmics, topical agents, and analgesics.
  • The treatment must be individualized.
  • Combination of different agents should be considered in some patients.
  • Slow dose escalation may improve drug tolerability.