Drugs currently used in the clinical management of neuropathic pain
| Drug | Target | Status |
|---|---|---|
| Gabapentinoids (pregabalin, gabapentin) | α2δ−1 auxiliary subunit of voltage-gated Ca2+ channels | First-line treatment (Finnerup et al., 2015) |
| Tricyclic antidepressants (amitriptyline) | Noradrenaline/Serotonin uptake systems | First-line treatment (Finnerup et al., 2015) |
| Noradrenaline/Serotonin uptake inhibitors (duloxetine) | Noradrenaline/Serotonin uptake systems | First-line treatment (Finnerup et al., 2015) |
| Tramadol | Opioid receptors and noradrenaline/serotonin uptake systems | Second-line treatment (Moulin et al., 2014) |
| Controlled release opioids | Opioid receptors | Second-line treatment (Moulin et al., 2014) |
| Cannabinoids | CB1 and CB2 receptors | Third-line treatment (Moulin et al., 2014) |
| Botulinum toxin | Neurotransmitter release | Fourth-line treatment (Moulin et al., 2014) |
| Methadone | Opioid and NMDA receptors | Fourth-line treatment (Moulin et al., 2014) |
| Lamotrigine | Voltage-gated Na+ channels; L-, P-, and N-type Ca2+ channels | Fourth-line treatment (Moulin et al., 2014) |
| Lacosamide | Slow inactivation of voltage-gated Na+ channels | Fourth-line treatment (Moulin et al., 2014) |
| Tapentadol | μ-Opioid receptors and noradrenaline uptake system | Fourth-line treatment (Moulin et al., 2014) |
| Carbemazepine | Voltage-gated Na+ channels and GABAA receptors | Use primarily restricted to trigeminal neuralgia (Demant et al., 2014) |
| Ziconotide (synthetic ω-conotoxin MVIIA) | N-type voltage-gated Ca2+ channels | Administered intrathecally when other treatments fail (McGivern, 2007) |
| Ketamine | NMDA receptors | Sometimes used clinically (Niesters et al., 2014; Maher et al., 2017) |
| Lidocaine patch | Voltage-gated Na+ channels | In clinical use (Finnerup et al., 2015) |
| Capsaicin patch | TRPV1 channels | In clinical use (Dworkin et al., 2007) |