Clinical neuropharmacology
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ADs have achieved popularity in the treatment of chronic pain syndromes associated with organic and psychogenic illness. This is surprising as there is little evidence from controlled studies that they are of value other than in the treatment of depression. There is good evidence for an intimate relationship between the neurotransmitters involved in the regulation of pain and mood and the mode of action of both opiates and antidepressants. ⋯ This would have important implications for improving knowledge of pain biochemistry and physiology. Few areas of modern therapeutic endeavour allow prescription of drugs in the absence of objective evidence of benefit. Current practice in chronic pain reflects the problems associated with psychological assessment in chronic physical illness, the complexity of chronic pain syndromes, and the natural desire to explore every avenue to relieve patients' symptoms.
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Recent advances in understanding the pathophysiology of status epilepticus (SE) have increased the urgency with which the study of this disorder should be approached. The clinical pharmacology of anticonvulsants useful in treating SE is reviewed and their application in several of the different types of SE is discussed. The potential for future advances is briefly considered.