Antidepressants in Neuropathic Pain
Neuropathic pain is pain caused by a lesion or dysfunction in the nervous system. In peripheral neuropathic pain, the lesion is located in the peripheral nervous system, and painful polyneuropathies (diabetic and non-diabetic), post-herpetic neuralgia and chronic pain after surgery (e.g. post-mastectomy pain syndrome) are prominent examples of this category of neuropathic pain. Post-stroke pain, pain after spinal cord injury, and pain in multiple sclerosis represent examples of central neuropathic pain conditions.
Antidepressants are drugs primarily developed to treat depression. The antidepressants that have been found to relieve neuropathic pain are tricyclic antidepressants(TCAs), serotonin noradrenaline reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs) and a dopamine noradrenaline reuptake inhibitor (DNRI). Within the pain field, the important drugs in these categories are TCAs: amitriptyline, imipramine, clomipramine, nortriptyline,...
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