Elsevier

Clinical Therapeutics

Volume 19, Issue 3, May–June 1997, Pages 420-432
Clinical Therapeutics

Nonsteroidal anti-inflammatory drugs, traditional opioids, and tramadol: constrating therapies for the treatment of chronic pain

https://doi.org/10.1016/S0149-2918(97)80127-0Get rights and content

Abstract

The treatment of chronic pain is an important function of physicians. In the United States, available drug treatments for chronic pain currently include simple analgesics such as acetaminophen, salicylates and other nonsteroidal anti-inflammatory drugs, traditional opioid drugs, and adjuvant agents (eg, antidepressants, anticonvulsants). Typically, the choice of a drug is made by balancing the indications for treatment, the clinical efficacy of the drug, and its toxicity. An understanding of the mechanism of action of these drugs helps to establish their role in therapy. Tramadol is an effective analgesic that works through a combined mechanism of weak mu receptor binding and the inhibition of serotonin and nonrepinephrine reuptake. Tramadol has a favorable adverse-effect profile and therefore is likely to have an important role in the management of chronic pain syndromes.

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