Dextromethorphan for chronic neuropathic pain in palliative care

ABSTRACTIntroduction: Chronic neuropathic pain is recognized as a major cause of poor quality of life due to the variable effectiveness of the existing analgesic therapies. In palliative care, chronic pain is often associated with depression, fatigue and other forms of ailments which up-regulate reciprocally. Dextromethorphan, a NMDA receptor antagonist was evaluated in various phenotypes of neuropathic pain but subsequently this was abandoned.Areas covered: Review of the literature on the clinical efficacy of dextromethorphan in neuropathic pain in an attempt to better position such a therapy in palliative care settings.Expert commentary: Dextromethorphan holds a good therapeutic potential in palliative care due to its analgesic, antidepressant and neuroprotective effects but further studies are needed to support this approach.