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Antidepressants for chronic pain

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https://www.readbyqxmd.com/read/29790353/-back-pain-treatment
#1
Marek Hakl
Spine pain is one of the most common medical problems. Yearly incidence is reported between 15 and 45 %, lifelong is 60-90 %. Neurological examination, radiology examination, CT or magnetic resonance imaging are the basic diagnostics. Acute back pain is usually treated monotherapeutically, NSAIDs is the base. Chronic back pain treatment is multidisciplinary, it combines pharmacotherapy, physiotherapy, psychotherapy and other methods. In pharmacotherapy we proceed according to the WHO three-step ladder, including strong opioid medication for strong back pain...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29765245/the-epidemiology-of-outpatient-pain-treatment-in-pediatrics
#2
Stacy Baldridge, Laura Wallace, Aditi Kadakia
Background: There is limited real-world, population-level data on the prevalence and treatment of pain in children. An understanding of pediatric pain conditions and its management can help inform provider education, treatment guidelines, and design of pediatric pain studies. Therefore, in this study, we aimed to describe the prevalence of conditions associated with acute and chronic pain in pediatric patients and to characterize pediatric pain treatment with nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 (COX-2) inhibitors, opioids (immediate release or extended release), antidepressants, topical analgesics, anticonvulsants, and other therapies based on a large, real-world sample...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29763654/obturator-neuromodulation-with-laparoscopic-placement-of-an-obturator-lead-for-the-treatment-of-intractable-opioid-dependent-chronic-pelvic-pain-due-to-obturator-neuralgia
#3
Richard P Marvel
Chronic pelvic pain(CPP) is a common condition in women that can have a devastating effect on quality of life. Some of the most severe forms of CPP are related to peripheral nerve injuries causing persistent neuropathic pain. This is a case of a young woman with severe opioid dependent chronic pelvic and right groin pain due to obturator neuralgia. She had failed a multitude of treatments including multiple medications, manual physical therapy, nerve blocks, surgical neurolysis and spinal cord stimulation without significant benefit...
May 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29742109/effect-of-single-dose-imipramine-on-chronic-low-back-and-experimental-pain-a-randomized-controlled-trial
#4
Jürg Schliessbach, Andreas Siegenthaler, Lukas Bütikofer, Andreas Limacher, Peter Juni, Pascal H Vuilleumier, Ulrike Stamer, Lars Arendt-Nielsen, Michele Curatolo
Antidepressants are frequently prescribed as co-analgesics in chronic pain. While their efficacy is well documented for neuropathic pain, the evidence is less clear in musculoskeletal pain conditions. The present study therefore evaluated the effect of the tricyclic antidepressant imipramine on chronic low-back pain in a randomized, double-blinded placebo-controlled design. To explore the mechanisms of action and the influence of drug metabolism, multimodal quantitative sensory tests (QST) and genotyping for cytochrome P450 2D6 (CYP2D6) were additionally performed...
2018: PloS One
https://www.readbyqxmd.com/read/29732584/giving-priority-to-preclinical-pain-measures-resistant-to-existing-drugs-for-developing-innovative-analgesics
#5
Yukinori Nagakura
Preclinical Research & Development Chronic pain is a major health and socioeconomic burden because of its high prevalence, negative influence on patients' physical and/or emotional conditions, and huge costs to society. The responses of chronic pain patients to analgesic therapies vary substantially from individual to individual, and no more than a minority of chronic pain patients with various etiologies such as neuropathy and inflammation are, in fact, successfully relieved by existing drugs including opioid analgesics, nonopioid analgesics, antiepileptics, and antidepressants...
May 6, 2018: Drug Development Research
https://www.readbyqxmd.com/read/29724663/effect-of-problem-solving-therapy-versus-supportive-management-in-older-adults-with-low-back-pain-and-depression-while-on-antidepressant-pharmacotherapy
#6
Jordan F Karp, Xiaotian Gao, Abdus S Wahed, Jennifer Q Morse, Bruce L Rollman, Debra K Weiner, Charles F Reynolds
OBJECTIVE: Testing stepped-care approaches that address both depression and low back pain are needed to optimize outcomes in older adults. METHODS: This university-based late-life depression research center assessed 227 adults aged ≥ 60 years with chronic low back pain and depression. In Phase 1 participants received 6 weeks of low-dose venlafaxine (≤150 mg/day). Nonresponders were randomized to 10 weeks of high-dose venlafaxine (up to 300 mg/day) plus problem-solving therapy (PST) or high-dose venlafaxine with supportive management...
March 30, 2018: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29714124/clinical-application-of-pharmacogenetics-in-pain-management
#7
D Max Smith, Kristin W Weitzel, Larisa H Cavallari, Amanda R Elsey, Siegfried Of Schmidt
There is growing experience translating genomic data into clinical practice, as seen with the Implementing GeNomics In pracTicE (IGNITE) network. A primary example is the influence of CYP2D6 genotype on the beneficial and adverse effects of some opioids. Clinical recommendations exist to guide drug therapy based on CYP2D6 genotype for codeine, tramadol, oxycodone and hydrocodone, although the level of supporting evidence differs by drug. Limited evidence also supports the use of genetic data to guide other medications in chronic pain therapy, including tricyclic antidepressants and celecoxib...
March 2018: Personalized Medicine
https://www.readbyqxmd.com/read/29678564/prescription-medication-use-among-community-based-us-adults-with-chronic-low-back-pain-a-cross-sectional-population-based-study
#8
Anna Shmagel, Linh Ngo, Kristine Ensrud, Robert Foley
Many classes of medications have been evaluated in chronic low back pain (cLBP), however their utilization in the community remains unclear. We examine patterns of prescription medication use among Americans with cLBP in a nationally representative, community-based sample. The Back Pain Survey was administered to a representative sample of US adults aged 20-69 (N = 5103) during the 2009-2010 cycle of the National Health and Nutrition Examination Survey (NHANES). cLBP was defined as self-reported pain in the area between the lower posterior margin of the ribcage and the horizontal gluteal fold on most days for at least 3 months (N = 700)...
April 17, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29671537/chronic-pancreatitis-diagnosis-and-treatment
#9
Kathleen Barry
Chronic pancreatitis is an irreversible and progressive disorder of the pancreas characterized by inflammation, fibrosis, and scarring. Exocrine and endocrine functions are lost, often leading to chronic pain. The etiology is multifactorial, although alcoholism is the most significant risk factor in adults. The average age at diagnosis is 35 to 55 years. If chronic pancreatitis is suspected, contrast-enhanced computed tomography is the best imaging modality for diagnosis. Computed tomography may be inconclusive in early stages of the disease, so other modalities such as magnetic resonance imaging, magnetic resonance cholangiopancreatography, or endoscopic ultrasonography with or without biopsy may be used...
March 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29606114/prognostic-factors-of-a-favorable-outcome-following-a-supervised-exercise-program-for-soldiers-with-sub-acute-and-chronic-low-back-pain
#10
Marc Perron, Chantal Gendron, Pierre Langevin, Jean Leblond, Marianne Roos, Jean-Sébastien Roy
BACKGROUND: Low back pain (LBP) encompasses heterogeneous patients unlikely to respond to a unique treatment. Identifying sub-groups of LBP may help to improve treatment outcomes. This is a hypothesis-setting study designed to create a clinical prediction rule (CPR) that will predict favorable outcomes in soldiers with sub-acute and chronic LBP participating in a multi-station exercise program. METHODS: Military members with LBP participated in a supervised program comprising 7 stations each consisting of exercises of increasing difficulty...
April 2, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29578822/pharmacotherapy-for-chronic-non-specific-low-back-pain-current-and-future-options
#11
Bart W Koes, Daan Backes, Patrick J E Bindels
Low back pain is associated with a large burden-of-illness. It is responsible for the most years lived with disability as compared with any other medical condition. A comprehensive overview of the evidence on pharmacological treatment options for chronic low back pain is lacking. This review evaluates the evidence for the benefits and risks of currently available pharmacological treatments for chronic low back pain. Areas covered: The authors focus on the recent (Cochrane) systematic reviews and meta-analyses of randomized clinical trials covering paracetamol (acetaminophen), NSAIDs, muscle relaxants, antidepressants, anticonvulsants, opioids, and other (new) drugs...
April 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29553987/chronic-postsurgical-pain-and-cancer-the-catch-of-surviving-the-unsurvivable
#12
Stephen R Humble, Nicolas Varela, Asantha Jayaweera, Arun Bhaskar
PURPOSE OF REVIEW: Chronic postsurgical pain (CPSP) is an important and well recognized cause of much long-term suffering, which in some cases may be preventable and affects many people living with cancer. Unfortunately, general consensus is lacking as to how best reduce the risk of developing CPSP. RECENT FINDINGS: Cancer is now not always a short-lived, fatal disease and is now moving towards a chronic illness. Poorly managed perioperative pain is the greatest risk factor for CPSP...
June 2018: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29509514/anesthetic-considerations-for-patients-on-antidepressant-therapy-part-ii
#13
Mana Saraghi, Leonard Golden, Elliot V Hersh
Millions of patients take antidepressant medications in the United States for the treatment of depression or anxiety disorders. Some antidepressants are prescribed off-label to treat problems such as chronic pain, low energy, and menstrual symptoms. Antidepressants are a broad and expansive group of medications, but the more common drug classes include tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and monoamine oxidase inhibitors. A miscellaneous or "atypical" category covers other agents...
2018: Anesthesia Progress
https://www.readbyqxmd.com/read/29480628/chikungunya-fever-general-and-oral-healthcare-implications
#14
J C Leao, Cdl Marques, Albp Duarte, O P de Almeida, S Porter, L A Gueiros
Chikungunya virus (CHIKV) was first isolated in humans in 1952, following an epidemic in Tanzania. The origin of the name means "to bend forward or become contorted," in reference to the posture adopted by patients due to the joint pain that occurs during the infection. Epidemiology data suggest that by the end of 2015, about 1.6 million people had been infected with CHIKV. The acute period of the disease is characterized by high fever, myalgia, joint pain, and severe and disabling polyarthritis, sometimes accompanied by headache, backache, and maculopapular rash, predominantly on the thorax...
March 2018: Oral Diseases
https://www.readbyqxmd.com/read/29460009/the-global-spine-care-initiative-applying-evidence-based-guidelines-on-the-non-invasive-management-of-back-and-neck-pain-to-low-and-middle-income-communities
#15
REVIEW
Roger Chou, Pierre Côté, Kristi Randhawa, Paola Torres, Hainan Yu, Margareta Nordin, Eric L Hurwitz, Scott Haldeman, Christine Cedraschi
PURPOSE: The purpose of this review was to develop recommendations for the management of spinal disorders in low-income communities, with a focus on non-invasive pharmacological and non-pharmacological therapies for non-specific low back and neck pain. METHODS: We synthesized two evidence-based clinical practice guidelines for the management of low back and neck pain. Our recommendations considered benefits, harms, quality of evidence, and costs, with attention to feasibility in medically underserved areas and low- and middle-income countries...
February 19, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29457627/combination-pharmacotherapy-for-the-treatment-of-fibromyalgia-in-adults
#16
REVIEW
Joelle Thorpe, Bonnie Shum, R Andrew Moore, Philip J Wiffen, Ian Gilron
BACKGROUND: Fibromyalgia is a chronic widespread pain condition affecting millions of people worldwide. Current pharmacotherapies are often ineffective and poorly tolerated. Combining different agents could provide superior pain relief and possibly also fewer side effects. OBJECTIVES: To assess the efficacy, safety, and tolerability of combination pharmacotherapy compared to monotherapy or placebo, or both, for the treatment of fibromyalgia pain in adults. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase to September 2017...
February 19, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29428122/depressive-disorder-anxiety-disorder-and-chronic-pain-multiple-manifestations-of-a-common-clinical-and-pathophysiological-core
#17
Cesar A Arango-Dávila, Hernán G Rincón-Hoyos
INTRODUCTION: A high proportion of depressive disorders are accompanied by anxious manifestations, just as depression and anxiety often present with many painful manifestations, or conversely, painful manifestations cause or worsen depressive and anxious expressions. There is increasingly more evidence of the pathophysiological, and neurophysiological and technical imaging similarity of pain and depression. METHODS: Narrative review of the pathophysiological and clinical aspects of depression and chronic pain comorbidity...
January 2018: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/29421449/potential-uses-of-isolated-toxin-peptides-in-neuropathic-pain-relief-a-literature-review
#18
REVIEW
Mousa K Hamad, Kevin He, Hael F Abdulrazeq, Ali M Mustafa, Robert Luceri, Naveed Kamal, Mohsin Ali, Jonathan Nakhla, Mohammad M Herzallah, Antonios Mammis
Neuropathic pain is a subset of chronic pain that is caused by neurons that are damaged or firing aberrantly in the peripheral or central nervous systems. The treatment guidelines for neuropathic pain include antidepressants, calcium channel α2 delta ligands, topical therapy, and opioids as a second-line option. Pharmacotherapy has not been effective in the treatment of neuropathic pain except in the treatment of trigeminal neuralgia with carbamazepine. The inability to properly treat neuropathic pain causes frustration in both the patients and their treating physicians...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29372020/pain-medication-and-long-qt-syndrome
#19
REVIEW
Christoph Klivinyi, Helmar Bornemann-Cimenti
Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes. The acquired form is most often attributable to administration of specific medications and/or electrolyte imbalance. This review provides insights into the risk for QT prolongation associated with drugs frequently used in the treatment of chronic pain. In the field of pain medicine all the major drug classes (i.e. NSAIDs, opioids, anticonvulsive and antidepressant drugs, cannabinoids, muscle relaxants) contain agents that increase the risk of QT prolongation...
January 2018: Korean Journal of Pain
https://www.readbyqxmd.com/read/29326058/sleep-architecture-is-altered-in-the-reserpine-induced-fibromyalgia-model-in-ovariectomized-rats
#20
Alberto Hernandez-Leon, Alonso Fernández-Guasti, Adrián Martínez, Francisco Pellicer, María Eva González-Trujano
Fibromyalgia (FM) is a musculoskeletal chronic pain syndrome with various concomitant symptoms like sleep disorders. FM patients are mainly women and menopause might play an important role in the altered processing of somatosensory information. Adverse effects and moderated efficacy of drugs promote treatment discontinuation by patients. Animal models of FM report pain and depression-like behaviors, but none of them have explored sleep disturbance as possible marker in the preclinic diagnostic. The aim of this study was to investigate alterations of the sleep architecture in the reserpine (RES)-induced FM model in ovarectomized (OVX) rats...
January 8, 2018: Behavioural Brain Research
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