Prakt. lékáren. 2009; 5(3): 130-134

Pharmacotherapy of chronic pain

MUDr. Petr Ševčík, Ph.D¹, MUDr. Hana Vacovská², MUDr. Vladimír Rohan², MUDr. Jiří Polívka CSc³

¹ Fakultní nemocnice Plzeň

² Neurologická klinika LF UK a FN Plzeň

³ Neonatologické oddělení, FN a LF UK, Plzeň

Effective treatment of chronic pain may significantly improve the quality of life. A brief overview of its mechanisms of origin and of

pharmacological treatment options is presented. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of treatment of

numerous causes of pain. However, they can cause bleeding into the stomach. Cyclooxygenase-2 (COX-2) inhibitors have a lower risk of

bleeding than nonselective COX inhibitors; however, they may not be more effective. A therapeutic trial with various NSAIDs may identify

an appropriate drug which is most effective in a particular patient. Although physicians are often reluctant to prescribing opioids

for chronic pain, using these drugs while clearly determining the goals and thoroughly monitoring the course of the treatment is appropriate.

Tricyclic antidepressants, anticonvulsants, psychopharmaceuticals, and other drugs play an important role in the treatment

of chronic and, in particular, neuropathic pain.

Keywords: pain, chronic pain, nonsteroidal anti-inflammatory drugs, NSAIDs, COX-2, opioids, antidepressants, anticonvulsants, psychopharmaceuticals.

Published: May 1, 2009  Show citation