Adjuvant Medication

Thursday, 03 March 2005 16:38
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Adjuvant analgesics such as antidepressants and anticonvulsants, have a primary indication other than for pain, but have also been found to be effective in providing pain relief.

Neuropathic pain may be poorly responsive to opiate medication (as discussed in my previous article on Opioid medication) Therefore other drugs are used as adjuncts to improve pain relief and possibly to enable a lower dose of opiate to be used, thereby avoiding unpleasant side effects due to high doses.

There are a variety of types of medication that may be used as adjuncts to opiates.

This article aims to give a broad outline of the possible treatments currently in clinical use to combat neuropathic pain of different origins, including due to spinal problems, diabetic neuropathy etc.

It will focus primarily on oral administration, with some mention of topical preparations and reference to intraspinal techniques, which will be discussed in a future companion article.

This article is the second part of a series looking at various modalities of treatment of neuropathic pain: a multimodal approach being the most effective way to provide some relief for what are often regarded as intractable problems which are frustrating for both patient and practitioner.  (The first article was entitled: TREATING CHRONIC PAIN WITH OPIOID MEDICATION ).

IMPORTANT NOTE:

Any reference to intraspinal or epidural administration of drugs is for completeness:

However, please note that ASG does not endorse the use of intraspinal medication due to the lack of data on safety in long-term use; also, invasive procedures carry the potential risk of causing/exacerbating arachnoiditis which is incurable and extremely difficult to treat even palliatively.