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Anxiolytics for chronic pain

Wei-Wei Chen, Xia Zhang, Wen-Juan Huang
Pain and anxiety are the most common neurological responses to many harmful or noxious stimuli and their management clinically is often challenging. Many of the frequently used morphine-based drugs, non-steroid anti-inflammatory drugs and acetaminophen, while efficient for treating pain, lead to patients suffering from several unwanted side effects. Melatonin, produced from the pineal body is a hormone of darkness, is involved in the control of circadian rhythms, and exerts a number of pharmacological effects...
October 2016: Experimental and Therapeutic Medicine
Dermot P Maher, Pauline Woo, Waylan Wong, Xiao Zhang, Roya Yumul, Charles Louy
OBJECTIVE: To determine perioperative treatments and events associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) responses among patients who undergo total hip arthroplasties (THAs) and total knee arthroplasties (TKAs). DESIGN: Retrospective analysis. SETTING: Single tertiary care, academic, urban, level 1 trauma center. PARTICIPANTS: Final cohort represents 301 consecutive surgical inpatients meeting criteria for evaluation by HCAHPS survey...
November 2016: Journal of Clinical Anesthesia
Chouki Chenaf, Jean-Luc Kabore, Jessica Delorme, Bruno Pereira, Aurélien Mulliez, Lucie Roche, Alain Eschalier, Noémie Delage, Nicolas Authier
: Codeine is a widely used opioid analgesic but studies on its misuse in chronic non-cancer pain (CNCP) are still lacking. The aim of this study was to assess the incidence of codeine shopping behavior in CNCP patients and to identify the associated risk factors. This was a population-based retrospective cohort study from the French health insurance claims database from 2004 to 2014. The main outcome was the one-year incidence of codeine shopping behavior defined as ≥1 day of overlapping prescriptions written by ≥2 different prescribers and filled in ≥3 different pharmacies...
September 1, 2016: Journal of Pain: Official Journal of the American Pain Society
I B Ushakov, S S Lubavskaya, G A Batishcheva, Yu N Chernov
The article presents data on peculiarities of chronic pancreatitis course in railway transport workers (engine operators, engine operator assistants, dispatchers) with anxious depressive disorders. Pain and dyspepsia in patients with affective disorders appeared to be constant and more intense than in the patients without concomitant anxious depression. Psychophysiologic tests in 83% of patients with comorbid conditions revealed significant psychomotor dullness manifested in reliable lower speed of visual motor reactions...
2016: Meditsina Truda i Promyshlennaia Ekologiia
Nélia Gouveia, Ana Rodrigues, Sofia Ramiro, Mónica Eusébio, Pedro M Machado, Helena Canhão, Jaime C Branco
OBJECTIVES: To analyze and characterize the intake profile of pain-relief drugs in a population-based study of adults with chronic low back pain (CLBP). METHODS: EpiReumaPt was a cross-sectional Portuguese population-based study (10,661 subjects). Self-reported active CLBP was considered to be low back pain on the day of enrollment and for ≥ 90 days. Prevalence and profile of analgesic intake was characterized among those self-reporting active CLBP, taking into account the intensity of pain and the World Health Organization (WHO) analgesic ladder...
May 21, 2016: Pain Practice: the Official Journal of World Institute of Pain
Alexandre Zeitler, Nisrine Kamoun, Stéphanie Goyon, Jérôme Wahis, Alexandre Charlet, Pierrick Poisbeau, Pascal Darbon
Pain is an emotion and neuropathic pain symptoms are modulated by supraspinal structures such as the amygdala. The central nucleus of the amygdala is often called the 'nociceptive amygdala', but little is known about the role of the basolateral amygdala. Here, we monitored the mechanical nociceptive thresholds in a mouse model of neuropathic pain and infused modulators of the glutamate/GABAergic transmission in the basolateral nucleus of the amygdala (BLA) via chronically-implanted cannulas. We found that an N-methyl-D-aspartate-type glutamate receptor antagonist (MK-801) exerted a potent antiallodynic effect, whereas a transient allodynia was induced after perfusion of bicuculline, a GABA(A) receptor antagonist...
April 2016: European Journal of Neuroscience
Bethany D Ashby, P Kaul
The sexual assault of girls and women in this country is estimated at around 20%. The development of post-traumatic stress disorder (PTSD) following sexual abuse and assault is one of the potential lingering aftereffects. This article will describe PTSD following sexual abuse and its impact on presenting complaints, such as sexually transmitted infections, contraception, and chronic pain, for the pediatric and adolescent gynecology (PAG) clinician. Treatment approaches, including the use of antidepressants and anxiolytics, as well as evidenced based psychotherapies, will be highlighted...
February 9, 2016: Journal of Pediatric and Adolescent Gynecology
Shuzhuo Zhang, Zerong You, Shuxing Wang, Jinsheng Yang, Lujia Yang, Yan Sun, Wenli Mi, Liling Yang, Michael F McCabe, Shiqian Shen, Lucy Chen, Jianren Mao
Neuropeptide S (NPS), an endogenous anxiolytic, has been shown to protect against chronic pain through interacting with its cognate NPS receptor (NPSR) in the brain. However, the cellular mechanism of this NPS action remains unclear. We report that NPS inhibits hyperpolarization-activated cyclic nucleotide-gated (HCN) channel current (Ih) in the rat's amygdala through activation of NPSR. This NPS effect is mediated through ERK1/2 phosphorylation in a subset of pyramidal-like neurons located in the medial amygdala...
June 2016: Neuropharmacology
Tone Blågestad, Inger H Nordhus, Janne Grønli, Lars B Engesæter, Sabine Ruths, Anette H Ranhoff, Bjørn Bjorvatn, Ståle Pallesen
Total hip arthroplasty (THA) has been shown to reduce pain and improve function. In addition, it is suggested that THA improves sleep and alleviates symptoms of anxiety and depression. Patients with chronic pain are frequent users of analgesic and psychotropic drugs and thereby risk adverse drug events. The impact of THA on such drug use has not been thoroughly investigated. Based on merged data from the Norwegian Prescription Database and the Norwegian Arthroplasty Register, this study sought to investigate redeemed medications in a complete population (N = 39,688) undergoing THA in 2005 to 2011...
March 2016: Pain
Liga Zvejniece, Edijs Vavers, Baiba Svalbe, Grigory Veinberg, Kristina Rizhanova, Vilnis Liepins, Ivars Kalvinsh, Maija Dambrova
Phenibut is clinically used anxiolytic, mood elevator and nootropic drug. R-phenibut is responsible for the pharmacological activity of racemic phenibut, and this activity correlates with its binding affinity for GABAB receptors. In contrast, S-phenibut does not bind to GABAB receptors. In this study, we assessed the binding affinities of R-phenibut, S-phenibut, baclofen and gabapentin (GBP) for the α2-δ subunit of the voltage-dependent calcium channel (VDCC) using a subunit-selective ligand, radiolabelled GBP...
October 2015: Pharmacology, Biochemistry, and Behavior
Guo-Qiang Wang, Cheng Cen, Chong Li, Shuai Cao, Ning Wang, Zheng Zhou, Xue-Mei Liu, Yu Xu, Na-Xi Tian, Ying Zhang, Jun Wang, Li-Ping Wang, Yun Wang
The medial prefrontal cortex (mPFC) is implicated in processing sensory-discriminative and affective pain. Nonetheless, the underlying mechanisms are poorly understood. Here we demonstrate a role for excitatory neurons in the prelimbic cortex (PL), a sub-region of mPFC, in the regulation of pain sensation and anxiety-like behaviours. Using a chronic inflammatory pain model, we show that lesion of the PL contralateral but not ipsilateral to the inflamed paw attenuates hyperalgesia and anxiety-like behaviours in rats...
2015: Nature Communications
Paulo Ricardo Marques Filho, Rafael Vercelino, Stefania Giotti Cioato, Liciane Fernandes Medeiros, Carla de Oliveira, Vanessa Leal Scarabelot, Andressa Souza, Joanna Ripoll Rozisky, Alexandre da Silva Quevedo, Lauren Naomi Spezia Adachi, Paulo Roberto S Sanches, Felipe Fregni, Wolnei Caumo, Iraci L S Torres
INTRODUCTION: Neuropathic pain (NP) is a chronic pain modality that usually results of damage in the somatosensory system. NP often shows insufficient response to classic analgesics and remains a challenge to medical treatment. The transcranial direct current stimulation (tDCS) is a non-invasive technique, which induces neuroplastic changes in central nervous system of animals and humans. The brain derived neurotrophic factor plays an important role in synaptic plasticity process. Behavior changes such as decreased locomotor and exploratory activities and anxiety disorders are common comorbidities associated with NP...
January 4, 2016: Progress in Neuro-psychopharmacology & Biological Psychiatry
Christopher E Ramsden, Daisy Zamora, Alexandros Makriyannis, JodiAnne T Wood, J Douglas Mann, Keturah R Faurot, Beth A MacIntosh, Sharon F Majchrzak-Hong, Jacklyn R Gross, Amber B Courville, John M Davis, Joseph R Hibbeln
UNLABELLED: Omega-3 and omega-6 fatty acids are biosynthetic precursors of endocannabinoids with antinociceptive, anxiolytic, and neurogenic properties. We recently reported that targeted dietary manipulation-increasing omega-3 fatty acids while reducing omega-6 linoleic acid (the H3-L6 intervention)-reduced headache pain and psychological distress among chronic headache patients. It is not yet known whether these clinical improvements were due to changes in endocannabinoids and related mediators derived from omega-3 and omega-6 fatty acids...
August 2015: Journal of Pain: Official Journal of the American Pain Society
Namkee G Choi, A Lynn Snow, Mark E Kunik
OBJECTIVES: Disabled, homebound individuals tend to suffer both chronic pain and depression; however, low-income, homebound older adults have been underexposed in pain and depression research. We examined the extent of pain frequency, intensity, and interference; the relationship between pain and depressive symptoms; and prescription analgesic use and its association with use of antidepressant and anxiolytic medications among these older adults. METHOD: The data came from the baseline assessment of 215 homebound individuals aged 50+ who were referred to a clinical trial of depression treatment...
August 2016: Aging & Mental Health
Amir Garakani, Andrew G Mitton
Lyme Disease, or Lyme Borreliosis, caused by Borrelia burgdorferi and spread by ticks, is mainly known to cause arthritis and neurological disorders but can also cause psychiatric symptoms such as depression and anxiety. We present a case of a 37-year-old man with no known psychiatric history who developed panic attacks, severe depressive symptoms and suicidal ideation, and neuromuscular complaints including back spasms, joint pain, myalgias, and neuropathic pain. These symptoms began 2 years after being successfully treated for a positive Lyme test after receiving a tick bite...
2015: Case Reports in Psychiatry
Hong-Liang Guo, Yong Xiao, Zhen Tian, Xu-Bo Li, Dong-Sheng Wang, Xin-Shang Wang, Zhi-Wu Zhang, Ming-Gao Zhao, Shui-Bing Liu
OBJECTIVE: Sesamin is known for its role in antioxidant, antiproliferative, antihypertensive, and neuroprotective activities. However, little is known about the role of sesamin in the development of emotional disorders. Here we investigated persistent inflammatory pain hypersensitivity and anxiety-like behaviors in the mouse suffering chronic pain. METHODS: Chronic inflammatory pain was induced by hind paw injection of complete Freund's adjuvant (CFA). Levels of protein were detected by Western blot...
July 2016: Nutritional Neuroscience
Vittorio Magri, Emanuela Marras, Antonella Restelli, Florian M E Wagenlehner, Gianpaolo Perletti
The complex network of etiological factors, signals and tissue responses involved in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) cannot be successfully targeted by a single therapeutic agent. Multimodal approaches to the therapy of CP/CPPS have been and are currently being tested, as in the frame of complex diagnostic-therapeutic phenotypic approaches such as the urinary, psychosocial, organ-specific, infection, neurological and muscle tenderness (UPOINTS) system. In this study, the effect of combination therapy on 914 patients diagnosed, phenotyped and treated in a single specialized prostatitis clinic was analyzed...
March 2015: Experimental and Therapeutic Medicine
Kohei Koga, Giannina Descalzi, Tao Chen, Hyoung-Gon Ko, Jinshan Lu, Shermaine Li, Junehee Son, TaeHyun Kim, Chuljung Kwak, Richard L Huganir, Ming-Gao Zhao, Bong-Kiun Kaang, Graham L Collingridge, Min Zhuo
Chronic pain can lead to anxiety and anxiety can enhance the sensation of pain. Unfortunately, little is known about the synaptic mechanisms that mediate these re-enforcing interactions. Here we characterized two forms of long-term potentiation (LTP) in the anterior cingulate cortex (ACC); a presynaptic form (pre-LTP) that requires kainate receptors and a postsynaptic form (post-LTP) that requires N-methyl-D-aspartate receptors. Pre-LTP also involves adenylyl cyclase and protein kinase A and is expressed via a mechanism involving hyperpolarization-activated cyclic nucleotide-gated (HCN) channels...
January 21, 2015: Neuron
Paul Chu Sin Chung, Helen L Keyworth, Elena Martin-Garcia, Pauline Charbogne, Emmanuel Darcq, Alexis Bailey, Dominique Filliol, Audrey Matifas, Grégory Scherrer, Abdel-Mouttalib Ouagazzal, Claire Gaveriaux-Ruff, Katia Befort, Rafael Maldonado, Ian Kitchen, Brigitte L Kieffer
BACKGROUND: The delta opioid receptor (DOR) is broadly expressed throughout the nervous system; it regulates chronic pain, emotional responses, motivation, and memory. Neural circuits underlying DOR activities have been poorly explored by genetic approaches. We used conditional mouse mutagenesis to elucidate receptor function in GABAergic neurons of the forebrain. METHODS: We characterized DOR distribution in the brain of Dlx5/6-CreXOprd1(fl/fl) (Dlx-DOR) mice and tested main central DOR functions through behavioral testing...
February 15, 2015: Biological Psychiatry
Burel R Goodin, Timothy J Ness, Meredith T Robbins
The treatment of chronic pain arising from deep tissues is currently inadequate and there is need for new pharmacological agents to provide analgesia. The endogenous paracrine hormone/neurotransmitter oxytocin is intimately involved in the modulation of multiple physiological and psychological functions. Recent experiments have given clear evidence for a role of oxytocin in the modulation of nociception. The present article reviews the existent human and basic science data related to the direct and indirect effects of oxytocin on pain...
2015: Current Pharmaceutical Design
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