Table 17.9
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Drug treatment of neuropathic pain
DrugPeripheral neuropathic pain NNTCentral neuropathic pain NNTMixed neuropathic pain NNTNNH

Antidepressants:

 

TCAD

 

SSRI

 

SNRI

 

Combined

2.1–2.8

 

6.8

 

5.5

 

3.3

4.0

 

-

 

-

 

4.0

-

 

-

 

-

 

1.6

14.7

 

-

 

-

 

16.7

Anticonvulsant drugs:

 

Phenytoin

 

Carbamazepin

 

GBP and PGB

 

Lamotrigine

 

Valproate

 

Topiramate

 

Combined

2.1

 

2.3

 

3.9–4.6

 

4.0–5.4

 

2.1–2.4

 

7.4

 

4.2

-

 

-

 

-

 

-

 

-

 

-

 

-

-

 

-

 

-

 

-

 

-

 

-

 

10.0

-

 

-

 

-

 

-

 

-

 

6.3

 

10.6

Opioids:

 

Strong opioids

 

Tramadol

2.3–3.0

 

3.5–4.8

-

 

-

2.1

 

-

17.1

 

9.0

NMDA antagonists:

 

Dextromethorphan

2.5–3.4

-

-

8.8

Antiarrhythmics:

 

Mexiletine

 

Topical lignocaine

2.2–7.8

 

4.4

-

 

-

-

 

-

-

 

-

Cannabinoids

-

3.4

9.5

-

Topical Capsaicin

3.2–11.0

-

-

11.5

DrugPeripheral neuropathic pain NNTCentral neuropathic pain NNTMixed neuropathic pain NNTNNH

Antidepressants:

 

TCAD

 

SSRI

 

SNRI

 

Combined

2.1–2.8

 

6.8

 

5.5

 

3.3

4.0

 

-

 

-

 

4.0

-

 

-

 

-

 

1.6

14.7

 

-

 

-

 

16.7

Anticonvulsant drugs:

 

Phenytoin

 

Carbamazepin

 

GBP and PGB

 

Lamotrigine

 

Valproate

 

Topiramate

 

Combined

2.1

 

2.3

 

3.9–4.6

 

4.0–5.4

 

2.1–2.4

 

7.4

 

4.2

-

 

-

 

-

 

-

 

-

 

-

 

-

-

 

-

 

-

 

-

 

-

 

-

 

10.0

-

 

-

 

-

 

-

 

-

 

6.3

 

10.6

Opioids:

 

Strong opioids

 

Tramadol

2.3–3.0

 

3.5–4.8

-

 

-

2.1

 

-

17.1

 

9.0

NMDA antagonists:

 

Dextromethorphan

2.5–3.4

-

-

8.8

Antiarrhythmics:

 

Mexiletine

 

Topical lignocaine

2.2–7.8

 

4.4

-

 

-

-

 

-

-

 

-

Cannabinoids

-

3.4

9.5

-

Topical Capsaicin

3.2–11.0

-

-

11.5

Pooled data, adapted from Finnerup et al. (2005)

Abbreviations: GBP: gabapentin; NNT: number needed to treat (see text for explanation); NNH: number needed to harm (see text for explanation); PGB: pregabalin; SNRI: selective noradrenaline and serotonin re-uptake inhibitors; SSRI: selective serotonin re-uptake inhibitors; TCAD: tricyclic antidepressant drugs

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