Treatment of neuropathic pain with venlafaxine

OBJECTIVE: To report a case of successful treatment of neuropathic pain wit h venlafaxine. CASE REPORT: A 39-year-old white woman presented with neuropathic back pain . The patient obtained 50% pain relief with consecutive use of amitriptylin e, desipramine, and imipramine. Anticholinergic effects prompted a switch t o extended-release venlafaxine 75 mg/d. Pain relief was as effective with t his therapy as with the tricyclic antidepressants. The absence of adverse e ffects allowed the patient to discontinue all laxatives. DISCUSSION: Venlafaxine is an antidepressant that inhibits reuptake of nore pinephrine and serotonin. This is the major mechanism by which tricyclic an tidepressants relieve neuropathic pain. Venlafaxine does not bind to muscar inic-cholinergic, histaminic or alpha (1)-adrenergic receptors responsible for the common adverse effects seen with tricyclic antidepressants. CONCLUSIONS: This report describes the efficacious use of venlafaxine in th e treatment of neuropathic pain. Double-blind, randomized, controlled trial s are needed to explore this further.