Selective inhibition of serotonin and norepinephrine reuptake is the mechanism of which drug used to treat neuropathic pain?

Selective inhibition of serotonin and norepinephrine reuptake is the mechanism of which drug used to treat neuropathic pain?

• A. Duloxetine
• B. Mexiletine
• C. Gabapentin
• D. Tramadol

Answer: (A)

Selective inhibition of serotonin and norepinephrine reuptake is the action of duloxetine, an SNRI. By blocking the reuptake transporters for these two neurotransmitters, it increases their levels in the synaptic cleft, enhancing the descending pain inhibitory pathways in the central nervous system. This modulation helps dampen abnormal pain signaling characteristic of neuropathic pain. Among the options, this mechanism aligns with duloxetine’s approved use for neuropathic pain. The other drugs work by different mechanisms—mexiletine blocks voltage-gated sodium channels, gabapentin modulates calcium channels via the alpha-2-delta subunit, and tramadol is mainly an opioid receptor agonist with some SNRI effects but not a selective SNRI for neuropathic pain.

Selective inhibition of serotonin and norepinephrine reuptake is the action of duloxetine, an SNRI. By blocking the reuptake transporters for these two neurotransmitters, it increases their levels in the synaptic cleft, enhancing the descending pain inhibitory pathways in the central nervous system. This modulation helps dampen abnormal pain signaling characteristic of neuropathic pain. Among the options, this mechanism aligns with duloxetine’s approved use for neuropathic pain. The other drugs work by different mechanisms—mexiletine blocks voltage-gated sodium channels, gabapentin modulates calcium channels via the alpha-2-delta subunit, and tramadol is mainly an opioid receptor agonist with some SNRI effects but not a selective SNRI for neuropathic pain.