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Chapter 24 - Drug synergy and therapeutic combinations

from Section 6 - The Management of Neuropathic Pain

Published online by Cambridge University Press:  05 December 2013

By
Stephan A. Schug
Edited by
Cory Toth  and
Dwight E. Moulin
Cory Toth
Affiliation:
Department of Neurology, University of Calgary
Dwight E. Moulin
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario
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Summary

This chapter assesses the current evidence for synergistic effects of medications in the treatment of neuropathic pain and the options for therapeutic combinations. There are currently a number of animal models, which are widely used to assess the efficacy of neuropathic pain treatments. Such animal models include streptozocin neuropathy as a potential model of peripheral neuropathy and sciatic nerve ligation described in a number of different models as a model of nerve injury. Many studies have consistently shown beneficial effects of combining two agents for the treatment of neuropathic pain, thereby supporting the rationale for combined treatment in humans. Most of the international treatment guidelines for neuropathic pain agree on a set of first-line treatments. These include topical lidocaine for localized peripheral neuropathic pain, antidepressants (Tricyclic antidepressants (TCAs) and Serotonin-norepinephrine reuptake inhibitors (SSNRIs)) and calcium channel alpha-2-delta ligands (gabapentin and pregabalin).

Keywords

tricyclic antidepressantsquality of lifesomatosensory cortexthalamusopioid analgesicsanticonvulsantcentral post-stroke pain
Type
Chapter
Information
Neuropathic Pain
Causes, Management and Understanding
 , pp. 290 - 298
Publisher: Cambridge University Press
Print publication year: 2013

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