Neuropathic pain (NP) is defined by the International Association for the Study of Pain as "pain initiated or caused by a primary lesion or dysfunction in the nervous system." A number of medications (oral or topical) are available for treating NP. Some medications may act by decreasing nerve excitability and conduction in sensory axons. Others may have effects on neural damage-related synaptic changes (particularly for central pain). However,the mechanism of action for various drugs varies substantially and in some cases is not well understood. The purpose of this review is to compare the effectiveness and harms of gabapentin, pregabalin, duloxetine, venlafaxine, and topical lidocaine (patch or gel) for neuropathic pain.
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