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Tapentadol, Buprenorphine, and Levorphanol for the Treatment of Neuropathic Pain: a Systematic Review

Current Pain and Headache Reports volume 25, Article number: 18 (2021) Cite this article

Abstract

Purpose of Review

The objective of this systematic review is to present the available evidence for the utilization of the atypical opioids tapentadol, buprenorphine, and levorphanol for the treatment of neuropathic pain.

Recent Findings

In total, 1619 articles were retrieved of which 10 studies were included. Of 5 included studies pertaining to tapentadol, 4 studies show tapentadol monotherapy to be effective for the treatment of diabetic peripheral neuropathy or chronic, radiating low back pain. Of the 3 studies included for buprenorphine, only one was a randomized controlled trial found not to have a statistically significant reduction in pain with TD buprenorphine likely due to very high withdrawal rates during the trial. Only 2 case reports were included from the available literature for levorphanol providing low-quality anecdotal evidence.

Summary

The role of tapentadol, buprenorphine, and levorphanol for neuropathic pain conditions requires robust research including randomized controlled trials to evaluate their efficacy and safety.

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Data Availability

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Authors and Affiliations

  1. Department of Rehabilitation and Regenerative Medicine, NewYork-Presbyterian, The University Hospital of Columbia and Cornell, New York, NY, USA

    Samantha C. Erosa

  2. Department of Anesthesiology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, USA

    Paul R. Haffey

  3. Division of Pain Medicine, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, USA

    Neel Mehta

  4. Department of Anesthesia and Critical Care, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, New York, USA

    Amitabh Gulati

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  1. Samantha C. Erosa
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Correspondence to Samantha C. Erosa.

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Conflict of Interest

Dr. Samantha Erosa and Dr. Paul Haffey have no conflicts of interest to report nor was any financial support received by any of the authors, either directly or indirectly, for this publication.

Dr. Amitabh Gulati is a consultant for Medtronic, Flowonix, and AIS. Dr. Neel Mehta is a consultant for Biodelivery Sciences, Nevro, Salix Pharmaceuticals, and Sollis Therapeutics.

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Erosa, S.C., Haffey, P.R., Mehta, N. et al. Tapentadol, Buprenorphine, and Levorphanol for the Treatment of Neuropathic Pain: a Systematic Review. Curr Pain Headache Rep 25, 18 (2021). https://doi.org/10.1007/s11916-020-00934-z

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  • DOI: https://doi.org/10.1007/s11916-020-00934-z

Keywords

  • Tapentadol
  • Buprenorphine
  • Levorphanol
  • Atypical opioid
  • Neuropathic pain