Exploration of Medicine

Table 1. Pharmacotherapy for nerve pain

Therapy	Drug class	Drugs	Mechanism of action	Adverse effects
First-line therapy	Calcium channel blockers	Gabapentin	It inhibits α₂δ subunit of VGCCs.	Peripheral swelling
	Calcium channel blockers	Pregabalin	It inhibits α₂δ subunit of VGCCs.	Peripheral swelling and increased bodyweight
	TCAs	Amitriptyline	It inhibits the reuptake of serotonin and norepinephrine.	Arrhythmia and suicide risk
	SNRI	Duloxetine, venlafaxine	These act by inhibiting the reuptake of serotonin and norepinephrine.	Ataxia, hyperhidrosis and hypertension
Second-line therapy	Opioids	Tramadol	It acts by binding to opioid receptors.	Seizures and ataxia
	Opioids	Tapentadol	It inhibits the reuptake of serotonin and norepinephrine.	Seizures and ataxia
	Topical treatments	Lidocaine	It acts by binding to sodium channels.	Local erythema, itching and pain
	Topical treatments	Capsaicin	It interacts chemically with sensory neurons for its action.	Pain and itching
Third-line therapy	Strong opioids	Morphine	It acts by binding to opioid receptors.	Dizziness and lethargy
Third-line therapy	Neurotoxins	Botulinum toxin	It acts by decreasing the release of acetylcholine.	Pain at injection site

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SNRI: serotonin-norepinephrine reuptake inhibitors; TCAs: tricyclic antidepressants; VGCCs: voltage-gated calcium channels

Declarations

Acknowledgments

Our sincere thanks to Paramveer Singh, Shadab Husain and Jamilur Rahman Ansari for editing the language of this manuscript. The authors gratefully acknowledge the contributions of the collaborators and co-workers mentioned in the cited reference. SC, R Kaur, and AG acknowledges K.R. Mangalam University, AW acknowledges Guru Gobind Singh Indraprastha University (GGSIPU). R Kadian gratefully acknowledges the support and cooperation from the Director of Ram Gopal College, Gurugram. MSA gratefully acknowledges the Vice Chancellor and Dean of Pharmacy, Shree Guru Gobind Singh Tricentenary University (SGTU) for their kind cooperation and support.

Author contributions

SC, AW, R Kaur, and AG: Conceptualization, Investigation, Writing—original draft, Writing—review & editing. R Kadian and MSA: Validation, Writing—review & editing, Supervision.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

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