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Table 3 Major pharmacological treatment for neuropathic pain and their basic mechanisms

From: Translational investigation and treatment of neuropathic pain

Compound

Mode of action

Antidepressants

 

   Nortriptyline

Inhibition of both serotonin and norepinephrine reuptake

   Desipramine

Inhibition of both serotonin and norepinephrine reuptake

   Duloxetine

Inhibition of both serotonin and norepinephrine reuptake

   Venlafaxine

Inhibition of both serotonin and norepinephrine reuptake

Anticonvulsants

 

   Gabapentin

Decreases release of glutamate, norepinephrine, and substance P, with ligands on α2-δ subunit of voltage

   Pregabalin

Decreases release of glutamate, norepinephrine, and substance P, with ligands on α2-δ subunit of voltage

Lacosamide

Decreases release of presynaptic transmitters, inhibition of voltage-gated sodium-channel.

Opioid agonists

 

   Morphine

μ-receptor agonism

Oxycodone

μ-receptor agonism

   Methadone

μ-receptor agonism,κ-receptor antagonism

   Levorphanol

μ-receptor agonism

   Tramadol

μ-receptor agonism, inhibition of norepinephrine and serotonin reuptake

Topical therapy

 

   5% lidocaine patch

Block of sodium channels

   High-dose capsaicin patch

Damage of nociceptive sensory axons, a highly selective activating ligand for TRPV1,.

   Botulinum toxin.

Inhibition of both the exocytosis of acetylcholine and some other neurotransmitters