Management of depression in the presence of pain symptoms

Pavel Mohr, Istvań Bitter, Jaromiŕ Sv̌estka, Erich Seifritz, Oguz Karamustafalioglu, Hannu Koponen, Norman Sartorius

Research output: Contribution to journalReview article

17 Citations (Scopus)

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 noradrenergic 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.

Original languageEnglish
Pages (from-to)4-13
Number of pages10
JournalPsychiatria Danubina
Volume22
Issue number1
Publication statusPublished - Feb 1 2010

Keywords

  • Analgesics
  • Anticonvulsants
  • Antidepressants
  • Depression
  • Pain
  • SNRI

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Mohr, P., Bitter, I., Sv̌estka, J., Seifritz, E., Karamustafalioglu, O., Koponen, H., & Sartorius, N. (2010). Management of depression in the presence of pain symptoms. Psychiatria Danubina, 22(1), 4-13.