The management challenges of chronic pain: the role of antidepressants

American Journal of Therapeutics
Robert L Barkin, J Fawcett

Abstract

Chronic pain is both difficult for patients to tolerate and for clinicians to treat effectively. It differs from other types of pain in etiology and impact, which in turn affects the duration and modalities of treatment options. Forty years of research have confirmed the efficacy of antidepressant agents in the management of chronic pain, yet these agents are used inadequately. A significant amount of evidence supports the use of the traditional tricyclic antidepressants (TCAs) in the management of chronic pain, but because of their acute synaptic effects on multiple, nontherapeutic receptor systems, they are associated with numerous undesirable side effects. The newer selective serotonin reuptake inhibitors (SSRIs) have, comparatively, only serotonin-receptor-mediated side effects. These agents have not been thoroughly studied in the treatment of chronic pain. Moreover, because SSRIs impact reuptake of only one monoamine system, it is plausible that they may be less efficacious than the TCAs in treating chronic pain. Venlafaxine, the first agent in the new class of serotonin (5-HT)-norepinephrine (NE) reuptake inhibitors, is unique because it inhibits reuptake of both 5-HT and NE (and to a lesser extent dopamine), as do some o...Continue Reading

Citations

Jul 9, 2004·Current Treatment Options in Gastroenterology·Yuri A. Saito, Jean C. Fox
Mar 13, 2002·Pharmacology, Biochemistry, and Behavior·Brian J Jones, Thomas P Blackburn
May 1, 2008·Rheumatology·S PerrotUNKNOWN CEDR (Cercle d'Etude de la Douleur en Rhumatologie France), French Rheumatological Society, Pain Study Section
May 21, 2003·American Journal of Therapeutics·Bill McCarbergSteven M Schmidt
Dec 17, 2004·Clinical Neuropharmacology·Mitsuhiro KamataHisashi Higuchi
May 23, 2008·American Journal of Therapeutics·Warren A Katz, Robert L Barkin
Sep 19, 2008·Journal of Medical Case Reports·Zaid Ahmad WaniShano Sheikh
Feb 1, 2007·Neuropsychiatric Disease and Treatment·Teruhiko Higuchi, Mike Briley
May 25, 2005·Clinics in Geriatric Medicine·Robert L BarkinDiana S Barkin
Oct 4, 2006·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Joel RaskinDavid J Goldstein
Aug 25, 2007·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Joachim F WernickeAmy S Chappell
May 28, 2004·Pharmacotherapy·Dale R GrotheDominick Albano
May 10, 2011·Expert Opinion on Pharmacotherapy·Dawn A Marcus
Mar 31, 2010·Disease-a-month : DM·Warren A Katz, Robert L Barkin
Jul 22, 2008·Rheumatic Diseases Clinics of North America·Serge PerrotFrançoise Laroche
Oct 9, 2003·Human Psychopharmacology·Mitsuhiro KamataHisashi Higuchi
Nov 13, 2001·American Journal of Therapeutics·R L Barkin
Jul 2, 2005·Journal of Psychiatric Practice·G S AlexopoulosR W Ross
Feb 24, 2006·European Journal of Pain : EJP·Serge PerrotRichard Trèves
Feb 12, 2005·Headache·Suleyman N OzyalcinRian Disci
Jul 29, 2009·Diabetes/metabolism Research and Reviews·Vladimir SkljarevskiDan Ziegler
Dec 14, 2006·Pain Practice : the Official Journal of World Institute of Pain·Kenneth C Jackson, Erin L St Onge
Mar 1, 2010·International Journal of Psychiatry in Clinical Practice·Mitsuhiro KamataKoichi Otani

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.