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Non-opioid Therapeutic Strategies
Adjuvant Medications

Primary pharmacological effect is not analgesia; Secondary effects ameliorate pain .
Examples:
• Anticonvulsants (……….)

Are considered as adjuvant therapy to treat (neuropathic pain) as trigeminal neuralgia and severe cases of
migraine.

Gabapentin (peripheral neuropathy, diabetic peripheral neuropathy, fibromyalgia),
Pregabalin, Carbamazepine (trigeminal neuralgia),
Valproic Acid (migraine),
T opiramate (trigeminal neuralgia)
• Antidepressants (……….)

These drugs relieve pain independent of their effects on depression perhaps due to their ability to
affect 5HT and noradrenergic neuro transmission.

TCA’s/Amitriptyline (PHN, DPN),
Venlafaxine (*non-FDA Approved),
Duloxetine (DPN)

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Adjuvant Medications..more

• Muscle Relaxers/Antispasmodics
Used to relief muscle spasm or spasticity.
Cyclobenzaprine, Tizanidine, Baclofen, Methocarbamol,
Metaxalone, Orphenadrine (not OTC except..)

• Topicals (OTC)
NSAIDS: Diclofenac, Ketoprofen,
Lidocaine (patches, ointment, cream, gel)
Capsaicin Cream

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