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Review
. 2014 Jan;7(1):22-32.
doi: 10.1177/1756285613501576.

Capsaicinoids in the treatment of neuropathic pain: a review

John F Peppin  1 , Marco Pappagallo  2
Affiliations
Review

Capsaicinoids in the treatment of neuropathic pain: a review

John F Peppin et al. Ther Adv Neurol Disord. 2014 Jan.

Abstract

The treatment of neuropathic pain is difficult. Oral pharmaceuticals have significant side effects, and treatment efficacy tends to be modest. The use of topical analgesics reduces the potential for systemic side effects and allows direct application of medications to the area of pain. The natural spicy substance, capsaicin, has historically been known for its topical use. Capsaicin, once applied to the skin, causes a brief initial sensitization followed by a prolonged desensitization of the local pain nerves. This occurs through stimulation of the transient receptor potential vanilloid-1 (TRPV1) expressing pain nerve fibers. While low-dose capsaicin has not resulted in good efficacy, the larger dose 8% topical capsaicin has had some of the best data currently available in the treatment of post-herpetic neuralgia (PHN) and other neuropathic conditions. This paper discusses the data currently existing for capsaicin 8% in the treatment of PHN. It further reviews data for the low-dose capsaicin products and the current status in the development of other capsaicinoids, e.g. resiniferotoxin, and high-concentration liquid capsaicin.

Keywords: TRPV1; capsaicin; capsaicinoids; neuropathic pain.

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Conflict of interest statement

Conflict of interest statement: In the last year, JP has received consulting and advising fees from Ameritox, Endo Pharmaceuticals, INSYS Therapeutics and Zogenix Pharmaceuticals. In the last year, MP has received consulting and advising fees from Grunenthal.

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