Treating neuropathic pain and comorbid affective disorders: Preclinical and clinical evidence

IF 2.5 3区医学 Q2 ANESTHESIOLOGY

Pain Practice Pub Date : 2024-04-04 DOI:10.1111/papr.13370

David Richer Araujo Coelho, Maia Gersten, Alma Sanchez Jimenez, Felipe Fregni, Paolo Cassano, Willians Fernando Vieira

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引用次数: 0

Abstract

IntroductionNeuropathic pain (NP) significantly impacts quality of life and often coexists with affective disorders such as anxiety and depression. Addressing both NP and its psychiatric manifestations requires a comprehensive understanding of therapeutic options. This study aimed to review the main pharmacological and non‐pharmacological treatments for NP and comorbid affective disorders to describe their mechanisms of action and how they are commonly used in clinical practice.MethodsA review was conducted across five electronic databases, focusing on pharmacological and non‐pharmacological treatments for NP and its associated affective disorders. The following combination of MeSH and title/abstract keywords were used: “neuropathic pain,” “affective disorders,” “depression,” “anxiety,” “treatment,” and “therapy.” Both animal and human studies were included to discuss the underlying therapeutic mechanisms of these interventions.ResultsPharmacological interventions, including antidepressants, anticonvulsants, and opioids, modulate neural synaptic transmission to alleviate NP. Topical agents, such as capsaicin, lidocaine patches, and botulinum toxin A, offer localized relief by desensitizing pain pathways. Some of these drugs, especially antidepressants, also treat comorbid affective disorders. Non‐pharmacological techniques, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and photobiomodulation therapy, modulate cortical activity and have shown promise for NP and mood disorders.ConclusionsThe interconnection between NP and comorbid affective disorders necessitates holistic therapeutic strategies. Some pharmacological treatments can be used for both conditions, and non‐pharmacological interventions have emerged as promising complementary approaches. Future research should explore novel molecular pathways to enhance treatment options for these interrelated conditions.

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治疗神经性疼痛和合并情感障碍：临床前和临床证据

导言神经病理性疼痛（NP）严重影响生活质量，并经常与焦虑和抑郁等情感障碍同时存在。要同时治疗神经病理性疼痛及其精神表现，就必须全面了解各种治疗方案。本研究旨在综述治疗 NP 和合并情感障碍的主要药物和非药物治疗方法，以描述其作用机制以及在临床实践中的常用方法。使用了以下 MeSH 和标题/摘要关键词组合："神经性疼痛"、"情感障碍"、"抑郁"、"焦虑"、"治疗 "和 "疗法"。结果药物干预，包括抗抑郁药、抗惊厥药和阿片类药物，可调节神经突触传递以缓解神经性疼痛。外用药物，如辣椒素、利多卡因贴片和 A 型肉毒杆菌毒素，可通过对疼痛通路脱敏来提供局部缓解。其中一些药物，尤其是抗抑郁药，还能治疗合并的情感障碍。非药物技术，包括重复经颅磁刺激、经颅直流电刺激和光生物调节疗法，可调节大脑皮层的活动，并显示出治疗 NP 和情绪障碍的前景。一些药物治疗方法可同时用于这两种疾病，而非药物干预方法则是一种很有前景的补充方法。未来的研究应探索新的分子途径，以加强这些相互关联疾病的治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain Practice ANESTHESIOLOGY-CLINICAL NEUROLOGY

CiteScore

5.60

自引率

3.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Pain Practice, the official journal of the World Institute of Pain, publishes international multidisciplinary articles on pain and analgesia that provide its readership with up-to-date research, evaluation methods, and techniques for pain management. Special sections including the Consultant’s Corner, Images in Pain Practice, Case Studies from Mayo, Tutorials, and the Evidence-Based Medicine combine to give pain researchers, pain clinicians and pain fellows in training a systematic approach to continuing education in pain medicine. Prior to publication, all articles and reviews undergo peer review by at least two experts in the field.