Review article

MANAGEMENT OF DEPRESSION IN THE PRESENCE OF PAIN SYMPTOMS

Pavel Mohr
István Bitter
Jaromír Švestka
Erich Seifritz
Oguz Karamustafalioglu
Hannu Koponen
Norman Sartorius

Abstract

Somatic illness is frequently associated with depression and anxiety and major depression significantly increases risk of severe medical conditions, e.g. cardiovascular illness. One of the most frequent comorbidities is that of depression and pain. Alterations in or adrenergic and serotonergic neurotransmissions in the central nervous system have been implicated in the joint pathophysiology of
depression and chronic pain. Antidepressants, alone or in combination with psychotherapy, are an effective treatment option in such cases. The newer dual action antidepressants (milnacipran, venlafaxine, duloxetine) acting specifically on both noradrenergic and serotonergic neurotransmitter systems are presumably more
reliable in pain management. So far, the most extensively studied drug has been duloxetine. Twelve randomized placebo-controlled trials with the total number of 4,108 patients suffering from pain associated with major depressive disorder suggested consistent analgesic efficacy of duloxetine, especially in fibromyalgia and
peripheral neuropathic pain.

Keywords

depression; pain; analgesics; anticonvulsants; antidepressants; SNRI

Hrčak ID:

48586

URI

https://hrcak.srce.hr/48586

Publication date:

10.2.2010.

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