Although this group of drugs comprises the local anesthetics and related "membrane-stabilizing" cardiac anti-arrhythmics, it should be appreciated that sodium channel inhibition is a property of many other groups of drugs, including many anticonvulsants, antidepressants, and "mainstream" analgesics such as pethidine (meperidine), and it is possible that at least some of the therapeutic effects of these drugs are mediated through sodium channel inhibition.
A systematic review has been undertaken of systemic local anesthetic-type drugs in chronic pain.50[I] The findings can be summarized as follows: the most convincing evidence for benefit is seen in neuropathic pain of peripheral nerve injury or peripheral neuropathy, with no evidence of benefit in dysesthesia from spinal cord injury or painful neuropathy (including plexopathy) in malignant disease. However, one recent publication supports their use in MS.51 [V]
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