A large body of research now supports the use of traditional psychiatric treatments in the management of chronic pain. Pharmacological treatments have proven effective for many different pain syndromes, especially neuropathic conditions. For any specific disease, no single algorithm can dictate the modalities of treatment to be prescribed. Several classes of medications have proven efficacy for the treatment of neuropathic pain. However, the relief provided by these medications is usually incomplete and difficult to predict in advance. The selection of a particular medication, or combination of medications, will depend on multiple factors. The disease itself may change over time such that the efficacy of a treatment is altered, one treatment may be selected over another based on the response to previous treatments, and the patient's psychiatric co-morbidity, temperament, coping skills, and life story cannot be neglected.