Neuropathic pain can develop after nerve lesions form at any level of the somatosensory nervous system, peripheral or central; the precise mechanisms that generate pain post-nerve injury are not wholly understood. Such complexity makes it difficult for physicians to diagnose and, consequently, determine an effective treatment for each patient. Primary care physicians and neurologists prescribe therapies from several drug classes, including antiepileptic drugs, antidepressants, NSAIDs, dual-acting opioid analgesics, and opioid analgesics, largely in an escalating sequence to provide patients with adequate analgesia, each of whom may respond differently to the therapies. Antiepileptic drugs and antidepressants are the patient-share leaders in treating neuropathic pain; opioid analgesics are reserved for later-line use for severe or unmanageable pain. Recent efforts in the United States have been implemented to curb the overprescription of opioid analgesics and thus reduce the risk of abuse/misuse associated with these therapies, efforts that are not expected to have much impact in the near future on prescribing of this drug class for neuropathic pain patients. The Current Treatment Overview provides insight into how neuropathic pain is treated and managed today, while the detailed, expanded analysis explores how U.S. primary care physicians and neurologists are treating neuropathic pain and the factors behind their treatment decisions.


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