Evidence-based pharmacological treatment of neuropathic pain syndromes

Neuropathic pain, caused or initiated by a primary lesion in the peripheral or central nervous system, can result in a dramatic reduction in the patient's quality of life. The expression neuropathic pain covers a heterogeneous group of conditions, including peripheral neuropathy, complex regional pain syndrome, trigeminal neuralgia and central pain. Neuropathic pain poorly responds to conventional analgesics. However, with appropriate therapy, a significant proportion of patients experience a substantial pain reduction. We present here an evidence-based review of the options for the treatment of neuropathic pain syndromes. Consideration is given to the mechanisms of action, numbers needed to treat (NNT), the recommended doses and the most frequent side-effects of the drugs for which consistent support has been found for treatment of these pain conditions.