7Ĭombination therapy, that is, the combination of different pharmacological treatments, has not been a part of guidelines until recently. 6 Finnerup et al, recently revised the worldwide applied NeP pharmacotherapy recommendations from the Special Interest Group on neuropathic pain concluding that there was a strong Grades of Recommendation Assessment, Development and Evaluation (GRADE) recommendation for use and proposal as first-line treatment for TCA, SNRI, pregabalin, and gabapentin.

The European guidelines for the pharmacological treatment of NeP issued by the European Federation of Neurological Societies recommend tricyclic antidepressants (TCA), gabapentin, and pregabalin as first-line treatment for the most common NeP conditions, including diabetic neuropathy where serotonin-noradrenaline reuptake inhibitors (SNRI) are also recommended.

The current Danish treatment algorithms 2 – 5 are founded on the evidence-based recommendations provided by the international pain societies. 1 Peripheral causes of NeP are for example, polyneuropathy, postherpetic neuralgia, postoperative pain, and posttraumatic neuralgia, while causes of central NeP are spinal cord injuries, stroke, and so on. Neuropathic pain (NeP) is triggered by a lesion or a disease affecting the somatosensory nervous system that alters its structure and function, so that pain occurs spontaneously and responses to noxious and innocuous stimuli are pathologically amplified.

Nucleo cmp forte alternative