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NMDA receptor antagonists for neuropathic pain

Authoring team

N-methyl-d-aspartate (NMDA) receptor antagonists (e.g. ketamine, dextromethorphan, memantine, and amantadine) may have a role in the management of neuropathic pain. These agents are increasingly used by specialists who manage neuropathic pain e.g. in pain clinics and specialist palliative care clinics.

  • Ketamine is generally used as an anaesthetic
    • however at sub-anaesthetic doses it acts as an analgesic by blocking the NMDA receptor in the dorsal horn
    • the NMDA receptor is thought to be activated in clinical states where hyperanalgesia and allodynia are present
    • often ketamine is administered parenterally

Reference:

  1. GP (July 5th 2004), 45-6.

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