Anticonvulsants and Antidepressants in Chronic Pain Management

Abstract

Epidemiological studies have found that 10.1 to 55.2% of people in various countries have chronic pain. Various medicines are prescribed, depending on whether the pain originates from tissue damage or is neuropathic. Evidence suggests that chronic pain from tissue inflammation or damage as in rheu-matoid arthritis and cancer pain is best treated with opioids and anti-inflammatory drugs, while for neuropathic pain where pain is caused by a damaged or dysfunctional nervous system other drugs may be more effective. Chronic pain is a global concern affecting people from all walks of life. As the epidemic of opioid misuse continues to grow, the need for balanced, multimodal approaches to the treatment of pain syndromes has become more apparent. These include medications which, though origi-nally designed to treat other pathologies, have demonstrated benefits in the treatment of chronic pain. This article is a review of the pharmacodynamics of various classes of antidepressants and anticonvulsants and the effects of these drugs on pain signaling and perception. Finally, recommendations for the use of such drugs in the patient with chronic pain are discussed.