Neuropathic Pain
Neuropathic pain is estimated to affect up to 7% of the population and is likely to be an ongoing complaint. It can have a significant impact on patient functioning and quality of life. The drugs used to treat neuropathic pain can be conveniently divided into two types: medications used to treat other conditions but found to be useful in reducing pain from nervous system damage, and analgesics.
Antiepileptic drugs have been used in pain management since the 1960s. Pregabalin, a relatively new antiepileptic drug, is also used in management of chronic neuropathic pain conditions.
Neuropathic pain, including postherpetic neuralgia, diabetic neuropathy, and fibromyalgia, responds well to pregabalin, although there is insufficient data at present to claim it should be used in all neuropathic pain. The Cochrane review found no clear evidence of beneficial effects of pregabalin in established acute postoperative pain, and no studies evaluated pregabalin in chronic nociceptive pain, like arthritis.
Because pregabalin is not for everyone, individualisation of treatment is needed to maximise pain relief and minimise adverse events.
In 2008, the Australian Pain Society issued a position statement on evidence-based recommendations for the pharmacological management of neuropathic pain. See www.tinyurl.com/23zvh2j
Australian Pain Society: www.apsoc.org.au, phone 02 2 9954 4400
Diabetes Austraila: www.diabetesaustralia.com.au/, phone 1300 136 588
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