[Verse 1] Neuropathic pain — the wire's misfiring, Ectopic discharge, the nerve ain't retiring, NeuPSIG laid the blueprint, three tiers clear, First-line agents, let me put 'em in your ear — TCAs reuptake both the nora and sero, Duloxetine, venlafaxine — SNRI heroes, Gabapentin, pregabalin, calcium channel bind, Alpha-two-delta subunit, quieting the grind, Paresthesia, allodynia, burning dysesthesia — Every misfired signal got a clinical sequela [Chorus] Prima linea — TCA, SNRI, gabapentinoid, Seconda linea — topical, tramadol, steroid-void, Terza linea — strong opioids, botulinum last resort, Tre livelli — three tiers, memorize the report, Prima, seconda, terza — ladder's how we climb, Algorithm's the blueprint, evidence is the paradigm [Verse 2] Condition-specific, gotta individualize, Diabetic neuropathy — duloxetine supervise, COMBO-DN proved the combo hits different — Nortriptyline plus gabapentin, synergy efficient, Postherpetic neuralgia — topical lidocaine patch, High-concentration capsaicin, vanilloid receptor catch, Trigeminal neuralgia — carbamazepine's the throne, Sodium channel blockade, microvascular's the zone, Chemotherapy-induced? Duloxetine's the move, Central post-stroke pain — TCA finds its groove [Chorus] Prima linea — TCA, SNRI, gabapentinoid, Seconda linea — topical, tramadol, steroid-void, Terza linea — strong opioids, botulinum last resort, Tre livelli — three tiers, memorize the report, Prima, seconda, terza — ladder's how we climb, Algorithm's the blueprint, evidence is the paradigm [Bridge] Now let me drop a rare word — nociceptive's known, But the real word here is *causalgia* — that burning moan, Reflex Sympathetic Dystrophy rebranded CRPS, Sympathetically maintained, ketamine breaks the stress, HIV neuropathy — lamotrigine, evidence thin, Spinal cord injury — pregabalin's discipline, The second rare word — *paroxysmal*, episodic lightning shot, Trigeminal volleys, carbamazepine hits the spot, Botulinum toxin — third-line, peripheral injection, Blocks presynaptic release, disrupts pain signal projection [Verse 3] Combination therapy — the COMBO-DN data's real, Two agents, different mechanisms, amplified the deal, Don't just stack drugs chasing additive sedation, Target distinct pathways — that's rational medication, Tramadol hits mu-opioid plus monoamine reuptake, Second-line positioning — weak opioid's the intake, Strong opioids third because dependence risk is steep, Opioid-induced hyperalgesia, paradox runs deep, Titrate slow, assess response, document the function, Pain scores plus quality of life — that's the real conjunction [Chorus] Prima linea — TCA, SNRI, gabapentinoid, Seconda linea — topical, tramadol, steroid-void, Terza linea — strong opioids, botulinum last resort, Tre livelli — three tiers, memorize the report, Prima, seconda, terza — ladder's how we climb, Algorithm's the blueprint, evidence is the paradigm
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