The Mechanisms of Neuropathic Pain: An Overview for Psychiatrists

Objective: To present an overview of the mechanisms of neuropathic pain. Method: An extensive review of the scientific literature. Results: Neuroplastic changes are described under the headings of: ectopic discharge, sensi-tization of sensory terminals, cross-excitation, neurotransmitter change, coupling between the sympathetic and sensory nervous systems, spinal cord reorganization, spinal cord increased excitability, spinal cord decreased in-hibition, supraspinal influences. Conclusions: These mechanisms increase our understanding of the patient with neuropathic pain and open the door for therapeutic advances in this field. They also extend our under-standing of the nature of the nervous system more generally, and may provide pathophysiologic models of psy-chiatric disorders (German J Psychiatry 2002: 5:34-39)