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Neuropathic pain: Evidence based recommendations.

作者信息

Moisset Xavier

机构信息

Clermont Auvergne University, University Hospital Center of Clermont-Ferrand, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand, France.

出版信息

Presse Med. 2024 Jun;53(2):104232. doi: 10.1016/j.lpm.2024.104232. Epub 2024 Apr 17.


DOI:10.1016/j.lpm.2024.104232
PMID:38641202
Abstract

Neuropathic pain continues to be a significant problem that lacks effective solutions for every single patient. In 2015, international guidelines (NeuPSIG) were published, while the French recommendations were updated in 2020. The purpose of this minireview is to provide an update on the process of developing evidence-based recommendations and explore potential changes to the current recommendations. Primary treatments for neuropathic pain include selective serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and venlafaxine, gabapentin, tricyclic antidepressants, as well as topical lidocaine and transcutaneous electrical nerve stimulation, which are specifically suggested for focal peripheral neuropathic pain. Pregabalin is a first line treatment according to international guidelines but second-line in the more recent French guidelines, due to lower efficacy seen in more recent studies and misuse risk. Additionally, tramadol, combination therapies, and psychotherapy as adjuncts are proposed second line; high-concentration capsaicin patches, and botulinum toxin A are proposed specifically for focal peripheral neuropathic pain. In cases where primary and secondary treatments prove insufficient, third-line options come into play. These include high-frequency repetitive transcranial magnetic stimulation (rTMS) targeting the motor cortex, spinal cord stimulation, and the use of strong opioids when no alternative is available. To ensure optimal management of neuropathic pain in real-life situations, it is imperative to disseminate these recommendations widely and secure the acceptance of practitioners. By doing so, we can bridge the gap between theory and practice, and enhance the overall care and treatment of individuals suffering from neuropathic pain.

摘要

相似文献

[1]
Neuropathic pain: Evidence based recommendations.

Presse Med. 2024-6

[2]
French guidelines for neuropathic pain: An update and commentary.

Rev Neurol (Paris). 2021-9

[3]
Pharmacological and non-pharmacological treatments for neuropathic pain: Systematic review and French recommendations.

Rev Neurol (Paris). 2020-4-7

[4]
Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis.

Lancet Neurol. 2015-2

[5]
Treatment of neuropathic pain: an overview of recent guidelines.

Am J Med. 2009-10

[6]
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Rev Neurol (Paris). 2018-10-11

[7]
[Update in the pharmacological treatment of neuropathic pain].

Semergen. 2019

[8]
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[9]
Pharmacotherapy and noninvasive neurostimulation for neuropathic pain.

Presse Med. 2024-6

[10]
Elucidation of pathophysiology and treatment of neuropathic pain.

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