Antidepressant Efficacy in Managing Nonspecific Chronic Lower Back Pain Among Older Adults: A Review.

IF 0.9 Q3 ANESTHESIOLOGY
Krzysztof Wilczyński, Adam Mazurski, Kornela Kotucha
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Abstract

This review evaluates the use of antidepressants in older patients for the treatment of nonspecific chronic lower back pain (LBP), emphasizing age-related physiological changes and common degenerative conditions in this age group. We conducted a comprehensive search targeting studies on antidepressant use in older patients with LBP. Selective serotonin reuptake inhibitors, while effective for mood regulation, show limited benefits for LBP. Serotonin-norepinephrine reuptake inhibitors, particularly duloxetine, demonstrate potential in managing LBP, though further research is needed to confirm these findings. Tricyclic antidepressants have shown potential for pain relief, with limited evidence for LBP, but have a substantial side effect profile, including cardiotoxicity, weight gain, and severe anticholinergic effects. The evidence for trazodone in the treatment of LBP is limited. When prescribing new medications for older adults, it is crucial to carefully consider the patient's overall health, potential drug interactions, and sensitivity to side effects, ensuring that the benefits of treatment outweigh the risks. This review underscores the need for further research to understand the long-term effects and benefits of antidepressants in older patients with LBP, aiming to balance pain relief, mood stabilization, and minimized side effects.

抗抑郁药在治疗老年人非特异性慢性腰背痛中的疗效:综述。
本综述评估了老年患者使用抗抑郁药治疗非特异性慢性下背痛(LBP)的情况,强调了与年龄相关的生理变化以及该年龄组常见的退行性病变。我们针对患有下背痛的老年患者使用抗抑郁药的研究进行了全面检索。选择性血清素再摄取抑制剂虽然能有效调节情绪,但对枸杞多糖症的疗效有限。血清素-去甲肾上腺素再摄取抑制剂,尤其是度洛西汀,显示出治疗枸杞痛的潜力,但还需要进一步的研究来证实这些发现。三环类抗抑郁药具有缓解疼痛的潜力,但用于枸杞痛的证据有限,但副作用较大,包括心脏毒性、体重增加和严重的抗胆碱能作用。曲唑酮治疗枸杞痛的证据有限。在为老年人开具新药处方时,必须仔细考虑患者的整体健康状况、潜在的药物相互作用以及对副作用的敏感性,确保治疗的益处大于风险。本综述强调了进一步研究的必要性,以了解抗抑郁药物对老年椎间盘突出症患者的长期影响和益处,从而在缓解疼痛、稳定情绪和减少副作用之间取得平衡。
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
CiteScore
1.60
自引率
9.10%
发文量
40
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