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Gepubliceerd in: Huisarts en wetenschap 12/2006

01-12-2006 | Beschouwing

De farmacologische behandeling van neuropathische pijn

Auteurs: dr. JH Vranken, MH van der Vegt

Gepubliceerd in: Huisarts en wetenschap | Uitgave 12/2006

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Samenvatting

Vranken JH, Van der Vegt MH. De farmacologische behandeling van neuropathische pijn. Huisarts Wet 2006;49(12):622-8.
Naar schatting lijdt 1% van de Nederlandse bevolking aan neuropathische pijn. De pijnklachten zijn het gevolg van neuroplasticiteit: functionele en/of structurele veranderingen in beschadigde zenuwen. Er zijn veel verschillende behandelingen voor neuropathische pijn, maar men is het er nog niet over eens welke behandeling het meest effectief is. Op basis van de beschikbare literatuur zou men de voorkeur kunnen geven aan tricyclische antidepressiva. De mogelijk ernstige bijwerkingen beperken echter de toepassingsmogelijkheden van deze analgetica. De anti-epileptica pregabaline en gabapentine stillen de neuropathische pijn ongeveer even goed, maar hebben minder bijwerkingen en geven minder kans op ernstige complicaties. Zij zijn een alternatief, maar helaas heeft niet meer dan 70% van de patiënten er baat bij. Bij de overige patiënten zouden combinaties van analgetica met verschillend werkingsmechanisme, waaronder opioïden, tot adequate pijnstilling kunnen leiden. Naar de effectiviteit van zulke combinaties is echter geen onderzoek gedaan, zodat we niet weten wat de optimale combinatie en het beste doseringsschema is. Uiteindelijk blijkt 10% van de naar een pijnpolikliniek verwezen patiënten met neuropathische pijn ongevoelig voor farmaca.
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Metagegevens
Titel
De farmacologische behandeling van neuropathische pijn
Auteurs
dr. JH Vranken
MH van der Vegt
Publicatiedatum
01-12-2006
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Huisarts en wetenschap / Uitgave 12/2006
Print ISSN: 0018-7070
Elektronisch ISSN: 1876-5912
DOI
https://doi.org/10.1007/BF03084969

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