Chronic Neuropathic Pain Treatments Evaluated in The Lancet Review

A recent systematic review and meta-analysis published in The Lancet Neurology evaluated the efficacy and safety of pharmacological and noninvasive neuromodulation treatments for chronic neuropathic pain in adults. The study included double-blind, randomized, placebo-controlled trials sourced from Embase, PubMed, the International Clinical Trials Registry, and ClinicalTrials.gov, covering neuromodulation trials from inception and pharmacological interventions from January 1, 2013, to February 12, 2024.

The analysis encompassed various interventions, including antidepressants, anticonvulsants, opioids, and noninvasive neuromodulation techniques such as transcranial magnetic stimulation and transcutaneous electrical nerve stimulation.The findings indicated that certain pharmacological treatments, particularly specific antidepressants and anticonvulsants, demonstrated moderate efficacy in reducing neuropathic pain intensity compared to placebo. Noninvasive neuromodulation techniques also showed promise, with some studies reporting significant pain relief, though results varied across different modalities and patient populations.

Safety profiles were generally acceptable, with adverse events varying depending on the intervention type. The study underscores the importance of individualized treatment approaches, considering patient-specific factors and the risk-benefit profiles of each therapy. The authors advocate for further high-quality research to optimize treatment strategies and improve outcomes for individuals suffering from chronic neuropathic pain.