Mini reviews in medicinal chemistry
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Pain is a complex disease that usually remains poorly treated or undertreated, especially the neuropathic pain caused by injury to the peripheral or central nervous system. Antagonists of the NMDA receptor complex have emerged as potential drugs for pain management. A strong case is being raised for non-competitive or uncompetitive antagonists with low-to-moderate affinity and fast on/offset kinetics as drugs with good therapeutic profiles, because of their reduced side effects.
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This review presents available clinical studies and new insights into mechanisms of analgesic effect and possible new routes of administration of antidepressant drugs. Older TCAs continue to be superior treatments. We focused on recent findings on newer antidepressants as analgesics. Their use should be supported by further controlled trials.