Recent findings surrounding topical antidepressants as analgesics and review of existing and emerging topical analgesics

Tricyclic antidepressants (TCAs) have been used for chronic pain management for decades; however, their potential use as topical analgesics is an area of new research. The article highlights recent findings relating to the mode of action of TCAs and summarizes results of animal testing of these agents as analgesics. A review of existing and emerging information regarding localized peripheral administration of other drugs by topical application is also included. Currently, topical administration of nonsteroidal anti-inflammatory drugs, opioids, capsaicin, local anesthetics, and alpha-adrenoceptor agonists is being used in a variety of clinical states. Preclinical data suggests the potential for drug development of additional topical formulations of a variety of agents. Collectively, this scientific evidence indicates that topical analgesics create an efficacious option for adjuvant drug therapy, with minimal risk of significant systemic absorption and drug-drug interactions.