Table 3

Major pharmacological treatment for neuropathic pain and their basic mechanisms

Compound

Mode of action

Antidepressants

Nortriptyline

Inhibition of both serotonin and norepinephrine reuptake

Desipramine

Inhibition of both serotonin and norepinephrine reuptake

Duloxetine

Inhibition of both serotonin and norepinephrine reuptake

Venlafaxine

Inhibition of both serotonin and norepinephrine reuptake

Anticonvulsants

Gabapentin

Decreases release of glutamate, norepinephrine, and substance P, with ligands on α2-δ subunit of voltage

Pregabalin

Decreases release of glutamate, norepinephrine, and substance P, with ligands on α2-δ subunit of voltage

Lacosamide

Decreases release of presynaptic transmitters, inhibition of voltage-gated sodium-channel.

Opioid agonists

Morphine

μ-receptor agonism

Oxycodone

μ-receptor agonism

Methadone

μ-receptor agonism,κ-receptor antagonism

Levorphanol

μ-receptor agonism

Tramadol

μ-receptor agonism, inhibition of norepinephrine and serotonin reuptake

Topical therapy

5% lidocaine patch

Block of sodium channels

High-dose capsaicin patch

Damage of nociceptive sensory axons, a highly selective activating ligand for TRPV1,.

Botulinum toxin.

Inhibition of both the exocytosis of acetylcholine and some other neurotransmitters

Xu et al. Molecular Pain 2012 8:15   doi:10.1186/1744-8069-8-15