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Topical Treatment of Localized Neuropathic Pain in the Elderly

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Abstract

The prevalence of neuropathic pain in the older population has been reported to be very high and is most commonly localized to a circumscribed area. Treatment failure is frequent in neuropathic pain and is accompanied by central side effects with recommended oral drugs acting on the central nervous system. A number of topical pharmaceuticals are available on prescription and also sold over the counter. This review in persons aged older than 60 years shows the efficacy of lidocaine 5% and capsaicin 8% for localized neuropathic pain while results with other pharmaceuticals are rather inconsistent. Local application of drugs has a very limited systemic effect and the pharmacological advantages of local over systemic treatment are particularly interesting in older persons who often have comorbidities and take multiple medications. However, more information is needed on the efficacy and safety of lidocaine 5% and capsaicin 8% in older old persons and on the long-term effects of these pharmaceuticals. These studies should also pave the way for research and development in the field of topical analgesics with a satisfactory level of evidence-based medicine.

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Authors and Affiliations

  1. Clinical Pharmacology Department, CPC/CIC Inserm 1405, Clermont-Ferrand University Hospital, Clermont-Ferrand, France

    Gisèle Pickering & Camille Lucchini

  2. Centre de Pharmacologie Clinique, CPC/CIC Inserm 1405, Bâtiment 3C, CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand Cedex 1, France

    Gisèle Pickering

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  1. Gisèle Pickering
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  2. Camille Lucchini
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Correspondence to Gisèle Pickering.

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Gisèle Pickering and Camille Lucchini have no conflicts of interest that are directly relevant to the content of this article.

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Pickering, G., Lucchini, C. Topical Treatment of Localized Neuropathic Pain in the Elderly. Drugs Aging 37, 83–89 (2020). https://doi.org/10.1007/s40266-019-00739-9

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