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In 2011, Nucynta ER, an extended release formulation of tapentadol, was released in the United States for management of moderate to severe chronic pain and received Food and Drug Administration approval the following year for the treatment of neuropathic pain associated with diabetic peripheral neuropathy. [61] [62]
In 2010, an evidence-based guideline sponsored by the International Association for the Study of Pain recommended nortriptyline as a first-line medication for neuropathic pain. [56] However, in a 2015 Cochrane systematic review the authors did not recommend nortriptyline as a first-line agent for neuropathic pain.
It is a commonly used medication for the treatment of neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central pain. [11] It is moderately effective: about 30–40% of those given gabapentin for diabetic neuropathy or postherpetic neuralgia have a meaningful benefit. [12]
A review of duloxetine found that it reduced pain and fatigue, and improved physical and mental performance compared to placebo. [41] The US Food and Drug Administration (FDA) approved the drug for the treatment of fibromyalgia in June 2008. [42] [43] It may be useful for chronic pain from osteoarthritis. [44] [45]
Caffeine when added to pain medications such as ibuprofen, may provide some additional benefit. [104] [105] Ketamine can be used instead of opioids for short-term pain. [106] Pain medications can cause paradoxical side effects, such as opioid-induced hyperalgesia (severe generalized pain caused by long-term opioid use). [107] [108]
Tiagabine is approved by U.S. Food and Drug Administration (FDA) as an adjunctive treatment for partial seizures in individuals of age 12 and up. It may also be prescribed off-label by physicians to treat anxiety disorders and panic disorder as well as neuropathic pain (including fibromyalgia). For anxiety and neuropathic pain, tiagabine is ...