Pharmacologic treatment of pain in polyneuropathy

摘要: Tricyclic antidepressants and anticonvulsants have become the mainstay in treatment of pain polyneuropathy. Within last decade, controlled trials shown that numerous other drugs relieve such pain. To estimate efficacy different treatments, authors identified all placebo-controlled calculated numbers needed to treat (NNT) obtain one patient with more than 50% relief. The NNT was 2.6 for tricyclic antidepressants, 6.7 selective serotonin reuptake inhibitors, 2.5 anticonvulsant sodium channel blockers, 4.1 calcium blocker gabapentin, 3.4 mixed opioid monoaminergic drug tramadol, as from a sufficiently large number patients. Favorable point estimates 1.9 NMDA-antagonist dextromethorphan L-dopa were determined limited data. For capsaicin, many exposed patients 5.9, but most data are controversial owing trial methodology. Finally, antiarrhythmic mexiletine 38, this value may be biased because lack dichotomous several positive trials. at moment still first choice, carbamazepine, tramadol tried if contraindications or tolerability problems encountered tricyclics.