Adjuvant Analgesics

Adjuvant analgesics are a diverse group of drugs that were originally developed for a primary indication other than pain. Many of these medications are currently used to enhance analgesia under specific circumstances [1]. Of interest, a few of these agents are currently used as primary analgesics for specific pain conditions as well as adjuvants in some other pain conditions. The proper use of adjuvant drugs is one of the keys to success in effective pain management. Since adjuvant analgesics are typically administered to patients who take multiple medications, decisions regarding administration and dosage must be made with a clear understanding of the stage of the disease and the goals of care [2,3]. Since adjuvants cause their own side effects, they are better be used when a patient cannot obtain satisfactory pain relief from a primary pain medication (ie, acetaminophen, nonsteroidal antiinflammatory drugs, opioids). As a general recommendation, adjuvants should not be used only to lower the opioid dose in functional patients whose pain is well controlled with minimum side effects.