Recommendations for the pharmacological management of neuropathic pain

An overview and literature update

Robert H. Dworkin, Alec B. O'Connor, Joseph Audette, Ralf Baron, Geoffrey K. Gourlay, Maija L. Haanpää, Joel L. Kent, Elliot J. Krane, Alyssa A. LeBel, Robert M. Levy, Sean C. Mackey, John Mayer, Christine Miaskowski, Srinivasa Naga Raja, Andrew S C Rice, Kenneth E. Schmader, Brett Stacey, Steven Stanos, Rolf Detlef Treede, Dennis C. Turk & 2 others Gary A. Walco, Christopher D. Wells

Research output: Contribution to journalArticle

Abstract

The Neuropathic Pain Special Interest Group of the International Association for the Study of Pain recently sponsored the development of evidence-based guidelines for the pharmacological treatment of neuropathic pain. Tricyclic antidepressants, dual reuptake inhibitors of serotonin and norepinephrine, calcium channel α2-δ ligands (ie, gabapentin and pregabalin), and topical lidocaine were recommended as first-line treatment options on the basis of the results of randomized clinical trials. Opioid analgesics and tramadol were recommended as second-line treatments that can be considered for first-line use in certain clinical circumstances. Results of several recent clinical trials have become available since the development of these guidelines. These studies have examined botulinum toxin, high-concentration capsaicin patch, lacosamide, selective serotonin reuptake inhibitors, and combination therapies in various neuropathic pain conditions. The increasing number of negative clinical trials of pharmacological treatments for neuropathic pain and ambiguities in the interpretation of these negative trials must also be considered in developing treatment guidelines. The objectives of the current article are to review the Neuropathic Pain Special Interest Group guidelines for the pharmacological management of neuropathic pain and to provide a brief overview of these recent studies.

Original languageEnglish (US)
JournalMayo Clinic Proceedings
Volume85
Issue number3 SUPPL.
DOIs
StatePublished - 2010

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Neuralgia
Pharmacology
Guidelines
Therapeutics
Clinical Trials
Tramadol
Public Opinion
Botulinum Toxins
Tricyclic Antidepressive Agents
Capsaicin
Serotonin Uptake Inhibitors
Calcium Channels
Lidocaine
Opioid Analgesics
Randomized Controlled Trials
Ligands

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Dworkin, R. H., O'Connor, A. B., Audette, J., Baron, R., Gourlay, G. K., Haanpää, M. L., ... Wells, C. D. (2010). Recommendations for the pharmacological management of neuropathic pain: An overview and literature update. Mayo Clinic Proceedings, 85(3 SUPPL.). https://doi.org/10.4065/mcp.2009.0649

Recommendations for the pharmacological management of neuropathic pain : An overview and literature update. / Dworkin, Robert H.; O'Connor, Alec B.; Audette, Joseph; Baron, Ralf; Gourlay, Geoffrey K.; Haanpää, Maija L.; Kent, Joel L.; Krane, Elliot J.; LeBel, Alyssa A.; Levy, Robert M.; Mackey, Sean C.; Mayer, John; Miaskowski, Christine; Raja, Srinivasa Naga; Rice, Andrew S C; Schmader, Kenneth E.; Stacey, Brett; Stanos, Steven; Treede, Rolf Detlef; Turk, Dennis C.; Walco, Gary A.; Wells, Christopher D.

In: Mayo Clinic Proceedings, Vol. 85, No. 3 SUPPL., 2010.

Research output: Contribution to journalArticle

Dworkin, RH, O'Connor, AB, Audette, J, Baron, R, Gourlay, GK, Haanpää, ML, Kent, JL, Krane, EJ, LeBel, AA, Levy, RM, Mackey, SC, Mayer, J, Miaskowski, C, Raja, SN, Rice, ASC, Schmader, KE, Stacey, B, Stanos, S, Treede, RD, Turk, DC, Walco, GA & Wells, CD 2010, 'Recommendations for the pharmacological management of neuropathic pain: An overview and literature update', Mayo Clinic Proceedings, vol. 85, no. 3 SUPPL.. https://doi.org/10.4065/mcp.2009.0649
Dworkin, Robert H. ; O'Connor, Alec B. ; Audette, Joseph ; Baron, Ralf ; Gourlay, Geoffrey K. ; Haanpää, Maija L. ; Kent, Joel L. ; Krane, Elliot J. ; LeBel, Alyssa A. ; Levy, Robert M. ; Mackey, Sean C. ; Mayer, John ; Miaskowski, Christine ; Raja, Srinivasa Naga ; Rice, Andrew S C ; Schmader, Kenneth E. ; Stacey, Brett ; Stanos, Steven ; Treede, Rolf Detlef ; Turk, Dennis C. ; Walco, Gary A. ; Wells, Christopher D. / Recommendations for the pharmacological management of neuropathic pain : An overview and literature update. In: Mayo Clinic Proceedings. 2010 ; Vol. 85, No. 3 SUPPL.
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