Role of antidepressant serotonin-norepinephrine reuptake inhibitors in the treatment of chronic pain Duloxetine is perhaps the most well-known serotonin-norepinephrine reuptake inhibitor (SNRI) agent used in the treatment of chronic pain. This medication and other SNRI agents have a dual mechanism of action (e.g., inhibition of both the reuptake of norepinephrine as well as serotonin). From …
Role of the tricyclic antidepressants in the treatment of chronic pain Multiple tricyclic antidepressants including amitriptyline, imipramine, doxepin, desipramine, and nortriptyline have consistently shown analgesic effects at doses typically lower than required to treat depression. Amitriptyline, doxepin, and imipramine tend to have a greater side effect burden than desimpramine and nortriptyline. However, it is extremely …
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Role of antidepressants in the treatment of chronic pain Antidepressants are among the most commonly prescribed medications for chronic symptoms. More than 30 placebo-controlled, double-blind studies suggest the effectiveness of antidepressants in the treatment of various types of chronic pain. Antidepressants may be clinically effective in treating for chronic pain through a direct analgesic effect, …
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Role of valproic acid for the treatment of chronic pain Similar to topiramate, the use of valproic acid to treat migraine is described elsewhere in this book. Controlled trials for neuropathic pain are lacking.
Role of lacosamide for the treatment of chronic pain Lacosamide is a novel sodium channel modulator. While animal studies have suggested that this AED may be helpful for the treatment of neuropathic pain, the FDA did not approve this drug for such in humans when presented with the clinical trial data. Nevertheless, there are published …
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Role of topiramate for the treatment of chronic pain Topiramate’s use in the treatment of migraine is described elsewhere in this book. Clinical experience, along with a few published studies and case series, suggest that there may be a role for its use in the treatment of neuropathic pain. Common side effects often preclude its …
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Role of lamotrigine for the treatment of chronic pain While very few controlled studies have been conducted and/or shown that lamotrigine may be effective in the treatment of chronic pain, there is some evidence to support its use as an add-on therapy for the treatment of trigeminal neuralgia. In addition, there is some evidence to …
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