Скачать или смотреть Peripheral Neuropathy | Management | First Line Drug Options

A recent systematic review reported an estimated population
prevalence of pain with neuropathic characteristics of between
6.9% and 10%.

For South Africa, no published prevalence studies of neuropathic pain could be found. However, there may be a higher prevalence than elsewhere due to the burden of HIV/AIDS and diabetes, both of which are often associated with painful peripheral neuropathies. The prevalence of neuropathic pain was reported as 23% among South African AIDS patients who had not received prior antiretroviral treatment.

Following an accurate diagnosis of neuropathic pain, pregabalin, gabapentin, low-dose tricyclic antidepressants (e.g. amitriptyline), and serotonin-norepinephrine reuptake inhibitors (duloxetine and venlafaxine) are all recommended as first-line options for the treatment of peripheral neuropathic pain. If the response is insufficient after 2 - 4 weeks, the recommended next step is to switch to a different class or combine different classes of agents.

Opioids should be reserved for use later in the treatment pathway if switching drugs and combination therapy fails.

Pyridoxine (vitamin B6) should be restricted for prevention and/or treatment of isoniazid-induced toxic neuropathies in eligible patients concurrently with “critical” toxin withdrawal