Current pharmacological treatment, guidelines and prospects

Over the last few years, an international consensus has been reached for the treatment of chronic neuropathic pain. On the basis of randomized clinical trials, medications recommended for neuropathic pain include antidepressants (tricyclic antidepressants, dual reuptake inhibitors of serotonin and norepinephrine), calcium channel alpha 2-delta ligands (i.e., gabapentin and pregabalin), topical lidocaine and opioids. The recommendations for clinical practice proposed by the French Society of Pain include a therapeutic algorithm and criteria for referral patient to a pain clinic by general practitioners. Current therapeutic perspectives include the development of drugs acting on novel targets as well as the pharmacological prevention of postoperative neuropathic pain.