Treatment of Neuropathic Pain with Venlafaxine

Abstract

OBJECTIVE:

To report a case of successful treatment of neuropathic pain with venlafaxine.

CASE REPORT:

A 39-year-old white woman presented with neuropathic back pain. The patient obtained 50% pain relief with consecutive use of amitriptyline, desipramine, and imipramine. Anticholinergic effects prompted a switch to extended-release venlafaxine 75 mg/d. Pain relief was as effective with this therapy as with the tricyclic antidepressants. The absence of adverse effects allowed the patient to discontinue all laxatives.

DISCUSSION:

Venlafaxine is an antidepressant that inhibits reuptake of norepinephrine and serotonin. This is the major mechanism by which tricyclic antidepressants relieve neuropathic pain. Venlafaxine does not bind to muscarinic-cholinergic, histaminic or α₁-adrenergic receptors responsible for the common adverse effects seen with tricyclic antidepressants.

CONCLUSIONS:

This report describes the efficacious use of venlafaxine in the treatment of neuropathic pain. Double-blind, randomized, controlled trials are needed to explore this further.