Management of Pain in Parkinson's Disease

Pharmacological Treatment Options

Gabapentinoids, such as pregabalin and gabapentina, are supported by high-quality studies for neuropathic pain and may be useful in Parkinson's disease, as recommended by the American Diabetes Association 1, 2
Antidepressants, including serotonin and norepinephrine reuptake inhibitors (SNRIs) like duloxetina and venlafaxina, have shown efficacy in neuropathic pain, according to the American Diabetes Association 1, 2
Tricyclic antidepressants, such as amitriptilina, may be effective but should be used with caution due to anticholinergic effects, especially in patients over 65 years old, as noted by the American Diabetes Association 1, 2

Capsaicina, available in 8% patch or 0.075% cream, may be considered in patients with contraindications for oral pharmacotherapy or who prefer topical treatments, as suggested by the American Diabetes Association and the Journal of Injury Function & Rehabilitation 1, 3
5% lidocaine patch may be useful for localized neuropathic pain, although evidence in Parkinson's disease is limited, according to the American Diabetes Association and Annals of Oncology 4, 5

Percutaneous electrical nerve stimulation may be considered as a treatment for neuropathic pain, as noted by the Journal of Injury Function & Rehabilitation 3

Opioids should be avoided for chronic pain management due to the risk of addiction, as recommended by the American Diabetes Association 1, 4
Tricyclic antidepressants can cause anticholinergic side effects that limit their use, especially in older adults, according to the American Diabetes Association 1, 2