Review of Current Literarure- TCA's Use in Neuropathic Pain

Introduction

Neuropathy is a pervasive, ongoing problem in the general population, especially in those over 40 years of age.

Neuropathic pain is defined by the International Association for the Study of Pain as pain arising from the somatosensory system and often described as a burning or stabbing sensation.

Tricyclic antidepressants (TCAs) became widely available for treatment of neuropathic pain in the 1960's and remain among the recommendations for treatment of neuropathy per The Fourth International Conference on the Mechanisms and Treatment of Neuropathic Pain.

TCAs are thought to inhibit neuropathic pain through their inhibition of reuptake of norepinephrine and serotonin, NMDA receptor antagonism, as well as sodium and calcium channel antagonism.

Despite their proven efficacy, TCAs must be used with caution as they can exhibit a number of severe adverse effects including tachycardia, arrhythmia, anticholinergic effects, and/or sexual dysfunction.