Gabapentinoids are presented as established first-line treatments for neuropathic pain. The review frames them as clinically important despite incomplete mechanistic understanding.
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gabapentinoids
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Opioids have limited effectiveness in neuropathic pain, and fewer than 35% of patients derive meaningful benefit from other therapeutic approaches.
Quoted textsource-backed
Opioids display limited effectiveness, and less than 35% of patients derive meaningful benefit from other therapeutic approaches.
Processes involved in the onset of neuropathic pain differ from those involved in its long-term maintenance.
Quoted textsource-backed
Processes involved in the onset of neuropathic pain differ from those involved in its long-term maintenance.
Drugs that affect multiple processes rather than a single specific target may offer the greatest promise for future neuropathic pain therapeutic development.
Quoted textsource-backed
We suggest that drugs that affect multiple processes, rather than a single specific target, show the greatest promise for future therapeutic development.
Gabapentinoid interactions with the α2δ-1 subunit of voltage-gated calcium channels produce multiple neuron type-specific actions in spinal cord and higher centers.
Quoted textsource-backed
Interactions of gabapentinoids with the α2δ-1 subunit of voltage-gated Ca2+ channels produce multiple and neuron type-specific actions in spinal cord and higher centers.
Excitatory processes are enhanced and inhibitory processes are attenuated in the spinal dorsal horn and throughout the somatosensory system, leading to central sensitization and allodynia.
Quoted textsource-backed
Excitatory processes are enhanced, and inhibitory processes are attenuated in the spinal dorsal horn and throughout the somatosensory system. This leads to central sensitization and aberrant processing such that tactile and innocuous thermal information is perceived as pain (allodynia).
Neuropathic pain arises from many parallel, interdependent, and time-dependent processes, including neuroimmune interactions at peripheral, spinal, and supraspinal levels.
Quoted textsource-backed
Many parallel, interdependent, and time-dependent processes, including neuroimmune interactions at the peripheral, supraspinal, and spinal levels, contribute to the etiology of this "disease of pain."
Gabapentinoids remain first-line treatments for neuropathic pain, but their mechanism of action is poorly understood.
Quoted textsource-backed
Despite this progress, the gabapentinoids retain their status as first-line treatments, yet their mechanism of action is poorly understood.