Pharmacologic basis for the use of selective norepinephrine reuptake inhibitors for the treatment of neuropathic pain conditions

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Abstract Introduction This article will review the pharmacologic and clinical evidence supporting the use of selective norepinephrine reuptake inhibitors, most notably atomoxetine, for the treatment of neuropathic pain states. Many medications initially marketed for psychiatric indications have gained widespread use for their analgesic properties after additional research. Methods In search of alternative treatments for neuropathic pain, current guidelines, published reviews, and primary literature, including both rodent and human trials, were reviewed. Results and Discussion The first group of medications to gain widespread use in pain management was the tricyclic antidepressants. As further research was completed and serotonin norepinephrine reuptake inhibitors began to be utilized for their analgesic properties, a growing body of evidence began to indicate that the analgesic properties of these medications were primarily due to the blockade of norepinephrine reuptake with serotonin playing only a minimal role.