Pharmacological Pain Management
In recent years, varieties of adjunct analgesics have been used to treat chronic pain syndromes, including NSAIDs, antidepressants, anticonvulsants, local anesthetics, topical agents, baclofen, and N-methyl-D-aspartate (NMDA) receptor antagonists.
Tricyclic antidepressants and anticonvulsants have been used as the first-line drugs in the treatment of neuropathic pain. If a patient does not respond to treatment with different agents within one drug class, agents from a second drug class may be added. When all first-line options have been exhausted, narcotic analgesics may provide some benefit, with the risks of tolerance and addiction.