An overview of analgesics - anticonvulsants, antidepressants, and other medications (Part 3)

Pain is classified by various descriptions. Chronic pain has been described as being neuropathic (due to nervous system lesions), nociceptive (due to tissue damage), or mixed (a combination of neuropathic and nociceptive). The addition of the term nociplastic pain is used to describe patients who ex...

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Main Authors: R. van Rensburg, H. Reuter
Format: Article
Language:English
Published: AOSIS 2019-07-01
Series:South African Family Practice
Subjects:
Online Access:https://safpj.co.za/index.php/safpj/article/view/4972
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author R. van Rensburg
H. Reuter
author_facet R. van Rensburg
H. Reuter
author_sort R. van Rensburg
collection DOAJ
description Pain is classified by various descriptions. Chronic pain has been described as being neuropathic (due to nervous system lesions), nociceptive (due to tissue damage), or mixed (a combination of neuropathic and nociceptive). The addition of the term nociplastic pain is used to describe patients who experience chronic pain without tissue damage or nervous system lesions. Chronic pain is often difficult to manage, particularly neuropathic pain. Evidence-based pharmacological treatment options include anticonvulsants and antidepressants. The choice of medication will depend on various factors, including patient profile, type of pain, and associated conditions. Medications with the best evidence of efficacy for first-line use in neuropathic pain are the gabapentinoids, carbamazepine, the tricyclic antidepressants, and the serotonin-noradrenaline reuptake inhibitors duloxetine and venlafaxine. The cannabinoids and ketamine are being actively investigated for use in chronic pain. Currently the cannabinoids’ potential benefit is outweighed by the adverse effects, and recommendations for the use of ketamine is limited by its parenteral route of administration and low evidence of efficacy in chronic pain.
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spelling doaj-art-012f757ae2f54d058b7994e240aba83c2025-08-20T04:03:13ZengAOSISSouth African Family Practice2078-61902078-62042019-07-01613596310.4102/safp.v61i3.49723948An overview of analgesics - anticonvulsants, antidepressants, and other medications (Part 3)R. van Rensburg0H. Reuter1Stellenbosch UniversityStellenbosch UniversityPain is classified by various descriptions. Chronic pain has been described as being neuropathic (due to nervous system lesions), nociceptive (due to tissue damage), or mixed (a combination of neuropathic and nociceptive). The addition of the term nociplastic pain is used to describe patients who experience chronic pain without tissue damage or nervous system lesions. Chronic pain is often difficult to manage, particularly neuropathic pain. Evidence-based pharmacological treatment options include anticonvulsants and antidepressants. The choice of medication will depend on various factors, including patient profile, type of pain, and associated conditions. Medications with the best evidence of efficacy for first-line use in neuropathic pain are the gabapentinoids, carbamazepine, the tricyclic antidepressants, and the serotonin-noradrenaline reuptake inhibitors duloxetine and venlafaxine. The cannabinoids and ketamine are being actively investigated for use in chronic pain. Currently the cannabinoids’ potential benefit is outweighed by the adverse effects, and recommendations for the use of ketamine is limited by its parenteral route of administration and low evidence of efficacy in chronic pain.https://safpj.co.za/index.php/safpj/article/view/4972neuropathic painanticonvulsantsantidepressantsevidence-basedcannabinoids
spellingShingle R. van Rensburg
H. Reuter
An overview of analgesics - anticonvulsants, antidepressants, and other medications (Part 3)
South African Family Practice
neuropathic pain
anticonvulsants
antidepressants
evidence-based
cannabinoids
title An overview of analgesics - anticonvulsants, antidepressants, and other medications (Part 3)
title_full An overview of analgesics - anticonvulsants, antidepressants, and other medications (Part 3)
title_fullStr An overview of analgesics - anticonvulsants, antidepressants, and other medications (Part 3)
title_full_unstemmed An overview of analgesics - anticonvulsants, antidepressants, and other medications (Part 3)
title_short An overview of analgesics - anticonvulsants, antidepressants, and other medications (Part 3)
title_sort overview of analgesics anticonvulsants antidepressants and other medications part 3
topic neuropathic pain
anticonvulsants
antidepressants
evidence-based
cannabinoids
url https://safpj.co.za/index.php/safpj/article/view/4972
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