Pharmacological and Non-pharmacological Approaches for the Management of Neuropathic Pain in Multiple Sclerosis

Multiple sclerosis is a chronic inflammatory disease that affects the central nervous system and can cause various types of pain including ongoing extremity pain, Lhermitte’s phenomenon, trigeminal neuralgia, and mixed pain. Neuropathic pain is a major concern for individuals with multiple sclerosis...

Full description

Saved in:
Bibliographic Details
Published in:CNS drugs 2024-03, Vol.38 (3), p.205-224
Main Authors: Shkodina, Anastasiia D., Bardhan, Mainak, Chopra, Hitesh, Anyagwa, Onyekachi Emmanuel, Pinchuk, Viktoriia A., Hryn, Kateryna V., Kryvchun, Anzhelina M., Boiko, Dmytro I., Suresh, Vinay, Verma, Amogh, Delva, Mykhailo Yu
Format: Article
Language:English
Subjects:
Acceptance and Commitment Therapy
Anticonvulsants
Anticonvulsants - therapeutic use
Antidepressants
Antidepressive Agents - therapeutic use
Baclofen
Benzodiazepines
Botulinum toxin
Carbamazepine
Central nervous system
Clinical trials
Cognitive ability
Comorbidity
Duloxetine
Gabapentin
Humans
Inflammatory diseases
Lamotrigine
Localization
Medicine
Medicine & Public Health
Multiple sclerosis
Multiple Sclerosis - drug therapy
Multiple Sclerosis - therapy
Muscle relaxants
Myelin
Naltrexone
Narcotics
Nervous system
Neuralgia
Neuralgia - drug therapy
Neuralgia - etiology
Neurology
Neurosciences
Neurosurgery
Observational studies
Pain
Patients
Pharmacotherapy
Phenytoin
Physical therapy
Psychiatry
Psychopharmacology
Psychotherapy
Review Article
Tricyclic antidepressants
Trigeminal nerve
Trigeminal Neuralgia - complications
Trigeminal Neuralgia - drug therapy
Venlafaxine
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Multiple sclerosis is a chronic inflammatory disease that affects the central nervous system and can cause various types of pain including ongoing extremity pain, Lhermitte’s phenomenon, trigeminal neuralgia, and mixed pain. Neuropathic pain is a major concern for individuals with multiple sclerosis as it is directly linked to myelin damage in the central nervous system and the management of neuropathic pain in multiple sclerosis is challenging as the options available have limited efficacy and can cause unpleasant side effects. The literature search was conducted across two databases, PubMed, and Google Scholar. Eligible studies included clinical trials, observational studies, meta-analyses, systematic reviews, and narrative reviews. The objective of this article is to provide an overview of literature on pharmacological and non-pharmacological strategies employed in the management of neuropathic pain in multiple sclerosis. Pharmacological options include cannabinoids, muscle relaxants (tizanidine, baclofen, dantrolene), anticonvulsants (benzodiazepines, gabapentin, phenytoin, carbamazepine, lamotrigine), antidepressants (duloxetine, venlafaxine, tricyclic antidepressants), opioids (naltrexone), and botulinum toxin variants, which have evidence from various clinical trials. Non-pharmacological approaches for trigeminal neuralgia may include neurosurgical methods. Non-invasive methods, physical therapy, and psychotherapy (cognitive behavioral therapy, acceptance and commitment therapy and mindfulness-based stress reduction) may be recommended for patients with neuropathic pain in multiple sclerosis. The choice of treatment depends on the severity and type of pain as well as other factors, such as patient preferences and comorbidities. There is a pressing need for healthcare professionals and researchers to prioritize the development of better strategies for managing multiple sclerosis-induced neuropathic pain.
ISSN:1172-7047
1179-1934
DOI:10.1007/s40263-024-01072-5