HOW DO DRUGS RELIEVE NEUROGENIC PAIN

Neurogenic pain is experienced by about 1% of the population. The effi cacy of drug treatment for this condition has been poorly evaluated, a nd only recently have certain treatments been shown to have significan t analgesic effects. Monotherapy with topical agents such as capsaicin is net usually sufficient. Oral agents that have proven effective in treating neurogenic pain states include tricyclic antidepressants, sel ective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors and a nticonvulsants. Local anaesthetics, administered intravenously, have b een reported to relieve pain in selected patients, but data from contr olled trials are sparse, Multiple mechanisms contribute to the generat ion of neurogenic pain. In the future, drug treatment for neurogenic p ain is likely to target these mechanisms. Recent studies have shown th at N-methyl-D-aspartate (NMDA) receptor antagonists, adenosine recepto r agonists and nitric oxide synthase inhibitors may become useful in t he treatment of neurogenic pain.