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Dextromethorphan, an NMDA receptor antagonist, as a Treatment for Pain

Author(s):  Mishkan Emilyn S

Issue:  Sep/Oct 2005 - Pain Management
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Abstract:  Recently discovered information on pain perception and amplification has pointed out the possible role of N-methyl-D-aspartate (NMDA) receptors in some types of pain and the potential efficacy of NMDA receptor antagonists in relieving this pain. Both animal and clinical research indicates that there is a place for dextromethorphan and other NMDA receptor antagonists in control of chronic nonmalignant pain syndromes such as peripheral diabetic neuropathy, postherpetic neuralgia, and fibromyalgia. For patients with chronic pain, a single daily dextromethorphan dose of 30 to 90 mg seems to be effective in managing pain symptoms and reducing analgesic requirements. Compounding pharmacists can tailor the therapy to the individual needs of patients, as there is much room for improvement in the available dosage forms. Further clinical trials are needed to determine optimal dosage regimens to minimize untoward effects and length of treatment necessary in chronic pain conditions to prevent relapse of symptoms.


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