Neurobiology of Neuropathic Pain: Mode of Action of Anticonvulsants

Eur J Pain. 2002;6 Suppl A:51-60. doi: 10.1053/eujp.2001.0323.

Abstract

Anticonvulsants are widely used for the treatment of neuropathic pain. Here we review the evidence for a number of peripheral and central changes after nerve injury that may provide a basis for the mechanisms of action of anticonvulsant therapies. The roles of sodium channels, calcium channels, and central glutamate mechanisms are emphasized as the main targets for anticonvulsant drugs in neuropathic pain states. The focus of this article is on anticonvulsants; however, opioids and antidepressants can also be effective in increasing inhibitions to control of pain in a manner similar to that of the enhancement of gamma-aminobutyric acid (GABA) function by antiepileptic drugs. A brief account of these approaches to neuropathic pain is also given.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Analgesics / pharmacology*
  • Animals
  • Anticonvulsants / pharmacology*
  • Calcium Channels / drug effects
  • Calcium Channels / metabolism
  • Humans
  • Neuralgia / drug therapy*
  • Neuralgia / metabolism
  • Neuralgia / physiopathology*
  • Neurons, Afferent / drug effects
  • Neurons, Afferent / metabolism
  • Peripheral Nervous System Diseases / drug therapy*
  • Peripheral Nervous System Diseases / metabolism
  • Peripheral Nervous System Diseases / physiopathology*
  • Receptors, N-Methyl-D-Aspartate / drug effects
  • Receptors, N-Methyl-D-Aspartate / metabolism
  • Spinal Cord / drug effects
  • Spinal Cord / metabolism
  • Spinal Cord / physiopathology
  • Synaptic Transmission / drug effects
  • Synaptic Transmission / physiology

Substances

  • Analgesics
  • Anticonvulsants
  • Calcium Channels
  • Receptors, N-Methyl-D-Aspartate