The use of NMDA-receptor antagonists
in the treatment of chronic pain

by
Hewitt DJ Department of Neurology,
Emory University Medical Center,
Atlanta, Georgia, USA.
David_Hewitt@emory.org
Clin J Pain 2000 Jun; 16(2 Suppl):S73-9


ABSTRACT

Chronic pain can be maintained by a state of sensitization within the central nervous system that is mediated in part by the excitatory amino acids glutamate and aspartate binding to the N-methyl-D-aspartate (NMDA) receptor. A number of antagonists to the NMDA receptor are antinociceptive in animal models but are associated with significant dose-limiting side effects. Commercially available NMDA-receptor antagonists include ketamine, dextromethorphan, memantine, and amantadine. The opioids methadone, dextropropoxyphene, and ketobemidone are also antagonists at the NMDA receptor. The NMDA-receptor antagonists have a significant impact on the development of tolerance to opioid analgesics. Consequently, NMDA-receptor antagonists may represent a new class of analgesics and may have potential as coanalgesics when used in combination with opioids.
Pain
Ketamine
Glutamate
Memantine
Pain and the NMDA receptor
NMDA antagonists for drug users
NMDA antagonists against morphine tolerance
NMDA antagonists, opioid receptors and tolerance
NMDA receptors and opiate-induced neural plasticity



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