Pain, especially neuropathic pain, is an area of largely unmet therapeutic need. The current pharmacological mainstays of clinical management for neuropathic pain are tricyclic anti-depressants and certain anti-convulsants.73,74 But these drugs only achieve clinically significant (greater than 50%) pain relief in less than 50% of patients and are associated with sub-optimal side-effect profiles. Opioids are still the drugs of choice although they are generally considered to be less effective in neuropathic pain than in inflammatory pain.
Further elucidation of the mechanisms underlying pain will assist in developing novel targets for drug therapy. Drugs that target the glia and its released chemical substances are predicted to be powerful remedies for pain problems. And for neuropathic pain, eventually, it may be possible to improve the quality of clinical management protocols so that there will be a move away from the current disease-based treatment towards symptoms or, ultimately, mechanism-based therapies.
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