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Mechanism-Based Pharmacological Treatment for Chronic Non-cancer Pain in Adolescents: Current Approaches and Future Directions

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Abstract

Chronic non-cancer pain in pediatrics is a widespread phenomenon that affects about 20% of adolescents (10–19 years old). Although interdisciplinary pain treatment programs, which often include pharmacological treatment, have emerged as the standard of care in management of this patient population, evidence regarding an optimal treatment is lacking. The efficacy and safety profiles of pharmacological treatments used to help adolescents suffering from chronic non-cancer pain remain understudied. This lack of evidence may increase polypharmacy and the risk of drug interactions and adverse events. This review examines evidence for the use of pharmacological treatments prescribed to treat chronic pain in adolescents (10–19 years old), with a focus on mechanism-based pharmacology. The objectives of this review are to: (a) review the evidence for mechanism-based pharmacological treatments for chronic non-cancer pain in adolescents and (b) describe the pharmacological agents that are commonly prescribed to manage chronic pain in adolescents, including dosage information, mechanism, and potential adverse effects. Pharmacological treatments should be used carefully with adolescents, ideally within an interdisciplinary treatment program that will incorporate physical rehabilitation, integrative medicine/active mind-body techniques, psychology, and global efforts to normalize daily activities.

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Authors and Affiliations

  1. Faculty of Medicine, McGill University, Montreal, QC, H3A 0C7, Canada

    Alice Bruneau

  2. Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada

    Sabrina Carrié, Lorenzo Moscaritolo & Pablo Ingelmo

  3. Department of Anaesthesia, McGill University, Montreal, QC, Canada

    Sabrina Carrié, Lorenzo Moscaritolo & Pablo Ingelmo

  4. Alan Edward Centre for Research on Pain, Montreal, QC, Canada

    Pablo Ingelmo

  5. Research Institute, McGill University Health Center, Montreal, QC, Canada

    Pablo Ingelmo

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  1. Alice Bruneau
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Correspondence to Alice Bruneau.

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Bruneau, A., Carrié, S., Moscaritolo, L. et al. Mechanism-Based Pharmacological Treatment for Chronic Non-cancer Pain in Adolescents: Current Approaches and Future Directions. Pediatr Drugs 24, 573–583 (2022). https://doi.org/10.1007/s40272-022-00534-x

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