Medications for Neuropathic Pain

Medications for neuropathic pain include antidepressants or tricyclic antidepressants (TCAs), anticonvulsants, and local anesthetics (e.g. mexiletine, tocainide, lidocaine).

There are many things that we know about neuropathic pain, and still many more incites waiting to be discovered. What we do know, is that the brain, which is the head of the nervous system, as well as literally the head of our body, relays all of the information coming from the various nerves of our body, and outputs information to our mind as pleasure, pain, of other sensory experiences. Our ability to think, sense, feel, and do things is based on all the signals the brain receives and interpret. If we were to experience pain, it would be based on the TOTALITY of signals that the brain received from the body as well as other areas of input from the spinal cord.

This concept of totality of signals is important, as it implies that other signals may compete with pain signals to influence whether we experience any pain at all, and if we do feel pain, what the severity of pain is. The human brain is a very complex organ in the human body, with many different specialized sections that allow us to have thoughts as well as autonomic body processes and conscious control of motor functions. Though there are many specialized parts of the brain, their specialized sections do not operate independently from one another. This means that there is not simply one section of the brain responsible for pain signals, one for conscious motor control, one for pleasure/comfort, and one for anxiety. There are sections of the brain with specialized purposes, but they influence each other. For example, the center of the brain responsible for emotion can channel inputs into the center that analyzes pain signals to either amplify or decrease the perception of pain.



This last concept is important, that the way we think and feel can affect the way that the brain interprets pain signals. Imagine a center of the brain that is bombarded with a steady stream of incoming signals saying that a certain section of the body have been injured. If no other messages were coming in but these pain signals, the brain would be more likely process this information and output pain signals that we feel and are affected by.

Now imagine that the person had the exact type of injury, with the same nerve fibers sending the same amount of pain signals to the brain. In this scenario, though, the brain was also receiving other signals from the brain, as the result of a emotionally positive emotional experience, such as a wonderful date with someone cared about. This emotional experience may not only be emotionally fulfilling for that individual, but may also result on the excitement of brain centers linked to the pain centers. If the same brain center were to receive signals from this emotional center as the result of a wonderful date, then the pleasure signals may actually override the pain signals, or modify the experience of pain to a much more moderate state.

There are also medications for neuropathic pain that may block or reduce the firing of fibers that send pain signals, or interrupt the transmission of pain signals to the brain. Medications for neuropathic pain include antidepressants or tricyclic antidepressants (TCAs), anticonvulsants, and local anesthetics (e.g. mexiletine, tocainide, lidocaine).