|
:::
 |
|
|
 |
|
Anti Depressant Drug |
|
 NSAIDs are a class of nonopioid analgesics that have anti-inflammatory, antipyretic, and analgesic properties. They are recommended for the relief of mild to moderate pain. If a strong inflammatory component is present, e.g., in acute back pain, the NSAIDs can be very effective. The use of NSAIDs for chronic back pain is limited because of the back of an inflammatory component.
|
|
Antidepressants |
|
The antidepressants are commonly used in the treatment of back pain. The analgesic doses are lower than the antidepressant doses. Whether the antidepressants actually treat underlying depression (which is known to exacerbate chronic pain) with a corresponding decrease in pain is unknown. However, it appears that these drugs have a direct analgesic effect on neuropathic pain condition. The antidepressants are most effective for diffuse, burning, and dysesthetic pain. Most patients can be managed at or below antidepressants doses. However, some patients may require antidepressant levels, in which case blood levels should be monitored. |
|
Anticonvulsants |
|
The anticonvulsant drugs have been demonstrated to be effective in pain syndromes with an intermittent lancinating quality. The anticonvulsants used in back pain management include carbamazepine, gabapentin, phenytoin, valproic acid, and clonazepam. They are generally started at low doses and gradually increased until the emergence of toxicity or intolerable side effects. The!ctherapeutic!aserum levels that apply for the treatment of epilepsy do not apply for pain management. Therefore, the drugs should be titrated to pain relief and side effects. |
|
Skeletal Muscle Relaxants |
|
The use of muscle relaxants is usually part of a therapeutic regimen!Fthey are rarely given alone. In conjunction with the opioids, NSIADs, and physical therapy, they can be quite effective in pain management. However, the long-term use of the skeletal muscle relaxants is controversial and is not recommended. The skeletal muscle relaxants are divided into the antispasmodics and the centrally acting muscle relaxants. |
|
|
|
|
