Blackburn-Munro G, Erichsen H K
Department of Pharmacology, NeuroSearch A/S, Pederstrupvej 93, DK-2750 Ballerup, Denmark.
Curr Pharm Des. 2005;11(23):2961-76. doi: 10.2174/1381612054865000.
Neuropathic pain is characterised by both positive (hyperalgesia and allodynia) and negative (sensory deficits) symptoms and remains intractable to many commonly used analgesics. Antiepileptics are increasingly utilised in the treatment of neuropathic pain. This class of drugs works via three major mechanisms of action in order to dampen neuronal hyperexcitability within the central nervous system: potentiation of GABA transmission, reduction of glutamate-mediated excitatory transmission, and block of voltage-activated ion channels. The latter mechanism of action in particular, is exemplified by the success of the newer generation of antiepileptics such as lamotrigine and gabapentin in the clinical treatment of neuropathic pain symptoms. In the current review article, we will examine in detail, the antinociceptive effects of a diverse range of antiepileptics as tested in animal models of nerve injury. Where appropriate, we will compare these findings with their analgesic efficacy in the clinical treatment of neuropathic pain.
神经性疼痛的特征在于既有阳性症状（痛觉过敏和异常性疼痛）又有阴性症状（感觉缺陷），并且对许多常用的镇痛药仍然难以治疗。抗癫痫药越来越多地用于治疗神经性疼痛。这类药物通过三种主要作用机制发挥作用，以抑制中枢神经系统内的神经元过度兴奋：增强GABA传递、减少谷氨酸介导的兴奋性传递以及阻断电压激活离子通道。尤其是后一种作用机制，以新一代抗癫痫药如拉莫三嗪和加巴喷丁在神经性疼痛症状的临床治疗中的成功为例。在当前的综述文章中，我们将详细研究在神经损伤动物模型中测试的多种抗癫痫药的镇痛作用。在适当的情况下，我们将把这些发现与它们在神经性疼痛临床治疗中的镇痛效果进行比较。
