Adjunct medication
There are a number of medications
whose primary purpose is not
analgesic but which have been
found to help reduce neuropathic
pain. These include antidepressants
and antiepileptics (British Geriatric
Society, 2013). Neuropathic pain
is associated with damage to the
peripheral or central nervous system.
The pain associated with neuropathic
pain is described as shooting,
burning, tingling or electric, but it
is not associated with movement
and can be highly sensitive to the
slightest touch. It also does not tend
to respond to conventional analgesia.
The assessment of this type of pain
is essential to ensure appropriate
treatment.
Antidepressants have been used
for a number of years to help with
---
neuropathic pain such as diabetic
neuropathy. The starting dose should
be low because it causes sedation.
They do not provide immediate pain
relief and patients should be asked
to persevere with the medication
for maximum benefit. The sideeffects,
including urinary retention,
sedation and postural hypotension
(increasing the risk of falls) and
cardiac arrhythmias, mean that
they are frequently discontinued by
patients (Bond and Simpson, 2006).