The pharmacological treatment of neuropathic pain

Neuropathic Pain (NP) as reported by IASP (International Association Study of Pain) is a "Pain arising as a direct consequence of a lesion or disease affecting the somatosensory system". In clinical practice NP is divided in peripheral and central pain and it is characterised by positive and negative symptoms. It is not so easy to plan out an effective therapy for this kind of pain. In this article we try to suggest a method to adapt drugs according to pain mechanisms and somatosensory pathways damages. In this "mechanisms based therapy", drugs and invasive procedures are used according to a complete examination (bedside and instrumental) of the patient's signs and symptoms. We describe characteristics of NP symptoms in order to individualise our therapeutic target and then we list the possible therapeutic drugs for these kinds of symptoms. (C) 2009 Published by Elsevier Ltd. on behalf of European Federation of International Association for the Study of Pain Chapters.