Pharmacological treatments of neuropathic pain: The latest recommendations

Rev Neurol (Paris). 2019 Jan-Feb;175(1-2):46-50. doi: 10.1016/j.neurol.2018.08.005. Epub 2018 Oct 11.


We provide an up-to-date review of the pharmacological treatment of neuropathic pain with emphasis on the latest evidence-based recommendations for its pharmacological treatment. Drugs proposed as first line include tricyclic antidepressants (particularly amitriptyline), serotonin-norepinephrine reuptake inhibitors (particularly duloxetine), pregabalin and gabapentin. Second line treatments include lidocaine plasters and capsaicin high concentration patches for peripheral neuropathic pain only, and tramadol. Third line treatments include strong opioids and botulinum toxin A (for peripheral neuropathic pain). Perspectives include the development of new compounds and a more personalized therapeutic approach, which is made possible by recent progress in the assessment and understanding of neuropathic pain.

Keywords: Neuropathic pain; Personalized medicine; Pharmacotherapy; Recommendations.

Publication types

  • Review

MeSH terms

  • Analgesics / classification
  • Analgesics / therapeutic use
  • Analgesics, Opioid / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Humans
  • Neuralgia / drug therapy*
  • Pain Management / methods*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use


  • Analgesics
  • Analgesics, Opioid
  • Antidepressive Agents
  • Serotonin Uptake Inhibitors