[Antiepileptic drugs and neuropathic pain]

Abstract

Introduction: This article is a bibliographic review of the part currently played by antiepileptic drugs in the treatment of neuropathic pain, and knowledge of their specific actions according to the different physiopathogenic mechanisms suspected of being involved in this type of pain.

Development: Neuropathic pain, the result of neurological damage in part of the nerve transmission system for pain, is one of the commonest painful syndromes in clinical practice and is a challenge for both neurologists and pain specialists. In recent years there has been increasing interest in the antiepileptic drugs, which were already used in this context in the sixties. Interest has increased with new drugs and better understanding of the physiopathogenic mechanisms of pain. The poor, variable response of these conditions to different treatments and the complex relationship between aetiologies, mechanisms and symptoms make it advisable to modify the traditional approach to the treatment of these conditions, passing form the aetiology and topographical distribution to the probable mechanisms involved in each individual patient, adapting the treatment to the individual concerned.

Conclusions: The antiepileptic drugs are one of the most promising approaches to the drug treatment of neuropathic pain. Their use as the sole treatment, or in combination with other treatment, in individual patients depends on better understanding of the mechanisms involved in the genesis and maintenance of neuropathic pain and how antiepileptic drugs act on these mechanisms.