University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
J Palliat Med. 2013 Jul;16(7):799-800. doi: 10.1089/jpm.2013.9497. Epub 2013 May 14.
TCAs, SNRIs, and the AEDs gabapentin and pregabalin are the best adjuvant analgesics for neuropathic pain. For patients who are intolerant to or who experience pain unresponsive to the above medications, one can consider therapy with carbamazepine, oxcarbazepine, valproic acid, topiramate, or lacosamide. However, as these agents are associated with more side effects and lower rates of efficacy, expert consultation is strongly recommended.
三环类抗抑郁药、选择性 5-羟色胺和去甲肾上腺素再摄取抑制剂，以及抗癫痫药加巴喷丁和普瑞巴林，是治疗神经病理性疼痛的最佳辅助镇痛药。对于不能耐受上述药物或对这些药物反应不佳的疼痛患者，可以考虑使用卡马西平、奥卡西平、丙戊酸、托吡酯或拉科酰胺进行治疗。然而，由于这些药物具有更多的副作用和较低的疗效，因此强烈建议咨询专家意见。
