Comparative Tolerability of the Newer Agents Used for the Treatment of Neuropathic Pain

Abstract

An increasing number of drugs are now available for the treatment of neuropathic pain. The evidence base that surrounds the use of the newer agents is, as yet, not as solid as those agents which have been available for some time. It does, however, appear that the majority of these newer agents, or new formulations of older agents, are at least as effective as those previously available, but with distinct advantages in terms of incidence and severity of side effects and hence have an increased chance of being tolerated by the patient. Insufficient evidence allows definitive statements regarding the comparative tolerability of the recently introduced agents. It appears that, in general, antiepileptic drugs are better tolerated than the antidepressants and that extended release opioids are better tolerated than those which are immediate release. As no one drug will relieve neuropathic pain in all suffers, the availability of a number of agents with enhanced tolerability when compared to older agents at least gives hope that further therapeutic options can be tried in the sufferer of neuropathic pain in whom the first intervention is unsuccessful.