E. Martin, Ph.D.; C. Narjoz, Ph.D., Pharm.D.; X. Decleves, Ph.D.; L. Labat, Ph.D.; C. Lambert, M.Sc.; et al
Anesthesiology 8 2019, Vol.131, 356-368
Neuropathic pain, defined as pain caused by a lesion or a disease of the somatosensory nervous system, affects 7 to 10% of the general population and is associated with central sensitization involving N-methyl-d-aspartate (NMDA) receptors. Neuropathic pain presents abnormal pain manifestations including allodynia and hyperalgesia and is accompanied by impaired quality of life. Management of neuropathic pain is still not satisfactory and in recent years, special attention has been focused on NMDA receptor antagonists, ketamine, memantine, and dextromethorphan. The analgesic mechanism of action of dextromethorphan, mainly used as a cough suppressant with safety hazards, remains incompletely known, however.
A preclinical study in a spinal nerve ligation animal model showed that postsurgical dextromethorphan administration induced a significant decrease of allodynia and hyperalgesia while preserving mobility and cognition in the Y-maze test. These positive findings in animals and in some clinical studies showing neuropathic pain alleviation after trauma and diabetes, although not universal, triggered an ongoing clinical trial (NCT02271893) in patients with refractory postsurgery neuropathic pain and central pain sensitization. Read More