Monoamines as Drug Targets in Chronic Pain: Focusing on Neuropathic Pain.

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Bravo L, Llorca-Torralba M, Berrocoso E, Mico JA

Monoamines as Drug Targets in Chronic Pain: Focusing on Neuropathic Pain.

Front Neurosci. 2019 Nov 26;13:1268. doi: 10.3389/fnins.2019.01268. eCollection 2019.

PubMed ID

31942167 [ View in PubMed

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Abstract

Monoamines are involved in regulating the endogenous pain system and indeed, peripheral and central monoaminergic dysfunction has been demonstrated in certain types of pain, particularly in neuropathic pain. Accordingly, drugs that modulate the monaminergic system and that were originally designed to treat depression are now considered to be first line treatments for certain types of neuropathic pain (e.g., serotonin and noradrenaline (and also dopamine) reuptake inhibitors). The analgesia induced by these drugs seems to be mediated by inhibiting the reuptake of these monoamines, thereby reinforcing the descending inhibitory pain pathways. Hence, it is of particular interest to study the monoaminergic mechanisms involved in the development and maintenance of chronic pain. Other analgesic drugs may also be used in combination with monoamines to facilitate descending pain inhibition (e.g., gabapentinoids and opioids) and such combinations are often also used to alleviate certain types of chronic pain. By contrast, while NSAIDs are thought to influence the monoaminergic system, they just produce consistent analgesia in inflammatory pain. Thus, in this review we will provide preclinical and clinical evidence of the role of monoamines in the modulation of chronic pain, reviewing how this system is implicated in the analgesic mechanism of action of antidepressants, gabapentinoids, atypical opioids, NSAIDs and histaminergic drugs.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Nortriptyline	5-hydroxytryptamine receptor 1A	Protein	Humans	Unknown	Antagonist	Details
Nortriptyline	5-hydroxytryptamine receptor 2A	Protein	Humans	Yes	Antagonist	Details