Douleur et Analgésie

, Volume 23, Issue 2, pp 93–98

Traitements pharmacologiques actuels, recommandations et perspectives

Mise Au Point / Update
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Résumé

Ces dernières années, un consensus thérapeutique s’est dégagé, tant sur un plan international que national, dans le traitement des douleurs neuropathiques chroniques. Cinq classes thérapeutiques ont fait la preuve de leur efficacité dans le soulagement de la douleur neuropathique chronique: antidépresseurs tricycliques, antidépresseurs inhibiteurs mixtes de la recapture de la sérotonine et de la norépinéphrine, antiépileptiques (gabapentine, prégabaline), lidocaïne topique et opioïdes. En France, les recommandations pour la pratique clinique de la Société française d’étude et de traitement de la douleur (SFETD) proposent une stratégie de prise en charge médicamenteuse, reposant sur l’efficacité et la sécurité d’emploi, et décrivent les étapes successives d’un traitement bien conduit ainsi que les critères pouvant conduire le médecin de ville à adresser le malade à un centre de la douleur. Les perspectives thérapeutiques actuelles s’orientent vers le développement de molécules actives sur de nouvelles cibles, mais également sur la prévention pharmacologique de la douleur neuropathique postopératoire.

Mots clés

Douleur neuropathique Traitement médicamenteux Recommandation 

Current pharmacological treatment, guidelines and prospects

Abstract

Over the last few years, an international consensus has been reached for the treatment of chronic neuropathic pain. On the basis of randomized clinical trials, medications recommended for neuropathic pain include antidepressants (tricyclic antidepressants, dual reuptake inhibitors of serotonin and norepinephrine), calcium channel alpha 2-delta ligands (i.e., gabapentin and pregabalin), topical lidocaine and opioids. The recommendations for clinical practice proposed by the French Society of Pain include a therapeutic algorithm and criteria for referral patient to a pain clinic by general practitioners. Current therapeutic perspectives include the development of drugs acting on novel targets as well as the pharmacological prevention of postoperative neuropathic pain.

Keywords

Neuropathic pain Treatment Guideline 

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Copyright information

© Médecine et Hygiène et Springer-Verlag France 2010

Authors and Affiliations

  1. 1.Service d’anesthésie-réanimationCHU Raymond-PoincaréGarchesFrance
  2. 2.Département d’évaluation et de traitement de la douleur, médecine palliativeCHU de Nice, hôpital PasteurNice cedex 01France
  3. 3.Inserm U929Clermont-FerrandFrance

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