scholarly journals Duloxetine for chronic pain

2021 ◽  
Vol 5 (10) ◽  
pp. 687-693
Author(s):  
E.V. Ekusheva ◽  
◽  
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Pain Syndrome ◽  
Modern Society ◽  
Developed Countries ◽  
Antidepressant Effect ◽  
Keywords Chronic Pain ◽  
Serotoninergic And Noradrenergic Systems ◽  
Anxiety Depression

Chronic pain is still a critical medical issue in modern society that results in severe deadaptation and reduces the quality of life in 15–40% of people in developed countries. Neuropathic pain is an essential issue characterized by recurrent course and the presence of comorbidities, e.g., depression. Duloxetine is particularly important among drugs with established efficacy prescribed for neuropathic pain. This agent significantly affects serotoninergic and noradrenergic systems and significant pathogenic mechanisms of the development of chronic pain, i.e., processes of disinhibition, thereby increasing the functional activity of the descending system of pain inhibition. The analgesic effect of duloxetine occurs much earlier and is independent of its antidepressant effect. Duloxetine is prescribed for many conditions that are often challenging for practitioners and associated with chronic pain. In addition, duloxetine has a significant effect on comorbid anxiety, depression, and sleep disorders. KEYWORDS: chronic pain, neuropathic pain, chronic pain syndrome, duloxetine. FOR CITATION: Ekusheva E.V. Duloxetine for chronic pain. Russian Medical Inquiry. 2021;5(10):687–693 (in Russ.). DOI: 10.32364/2587- 6821-2021-5-10-687-693.

scholarly journals Neuropathic pain in rheumatoid arthritis

2020 ◽  
Vol 12 (5) ◽  
pp. 60-65
Author(s):  
E. S. Filatova ◽  
A. M. Lila ◽  
V. A. Parfenov
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Chronic Pain ◽  
Nervous System ◽  
Neuropathic Pain ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Paindetect Questionnaire ◽  
Somatosensory Nervous System

Objective: to identify the signs of neuropathic pain (NP) in patients with rheumatoid arthritis (RA) on the basis of the PainDETECT questionnaire and neurological examination.Patients and methods. A total of 208 RA patients (39 men and 169 women; mean age, 47.7 years) with chronic pain syndrome were examined. The patients underwent rheumatological and neurological examinations; NP was diagnosed using the PainDETECT questionnaire; inflammation severity (DAS28 index), pain intensity (VAS), affective disorders (HADS), and quality of life (EQ-5D) were assessed.Results and discussion. 172 (82.7%) patients had moderate and high disease activity according to the DAS28. The signs of possible and highly probable NP according to the PainDETECT questionnaire were detected in 29.8 and 26.9% of patients, respectively; they were significantly more likely to be detected in patients with more severe pain syndrome, clinically significant anxiety, and worse quality of life, but were unassociated with RA activity according to the DAS28. Somatosensory nervous system injury (polyneuropathy, tunnel syndromes, and cervical myelopathy) was found in 77.6% of patients with possible NP and in 80.4% with highly probable NP. In other patients, NP might be caused by central sensitization. Conclusion. In patients with a RA exacerbation, chronic pain syndrome is caused not only by an active inflammatory process in the joint area and adjacent tissues, but also by somatosensory nervous system injury and central sensitization.

scholarly journals Buprenorphine: Far Beyond the “Ceiling”

Biomolecules ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 816
Author(s):  
Rosmara Infantino ◽  
Consalvo Mattia ◽  
Pamela Locarini ◽  
Antonio Luigi Pastore ◽  
Sabatino Maione ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Drug Abuse ◽  
Side Effects ◽  
National Health System ◽  
Analgesic Drugs ◽  
Third Line ◽  
Dynamic Profile

Chronic pain, including neuropathic pain, represents an untreated disease with important repercussions on the quality of life and huge costs on the national health system. It is well known that opioids are the most powerful analgesic drugs, but they represent the second or third line in neuropathic pain, that remain difficult to manage. Moreover, these drugs show several side effects that limit their use. In addition, opioids possess addictive properties that are associated with misuse and drug abuse. Among available opioids compounds, buprenorphine has been suggested advantageous for a series of clinical reasons, including the effectiveness in neuropathic pain. Some properties are partly explained by its unique pharmacological characteristics. However, questions on the dynamic profile remain to be answered. Pharmacokinetics optimization strategies, and additional potentialities, are still to be explored. In this paper, we attempt to conceptualize the potential undiscovered dynamic profile of buprenorphine.

scholarly journals The nature and prevalence of chronic pain in homeless persons: an observational study

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 164 ◽  
Author(s):  
Rebecca Fisher ◽  
Judith Ewing ◽  
Alice Garrett ◽  
E Katherine Harrison ◽  
Kimberly KT Lwin ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Short Form ◽  
Homeless People ◽  
Brief Pain Inventory ◽  
Homeless Persons ◽  
Lower Limbs ◽  
Mcgill Pain Questionnaire ◽  
Wide Range

Background: Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs.Methods: We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant’s reasons for homelessness, and whether they slept rough or in shelters.Findings: Of 168 shelter users approached, 150 (89.3%) participated: 93 participants (63%) reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs.Interpretation: The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable people’s lives.

Bladder Pain: The Patient Perspective

2017 ◽  
Vol 84 (1_suppl) ◽  
pp. 5-7 ◽  
Author(s):  
Jane M. Meijlink
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Urinary Tract ◽  
Patient Perspective ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Practical Support ◽  
Tract Infections

Patients with chronic pain, discomfort and other urinary symptoms related to bladder pain syndrome or urinary tract infections may experience severely diminished quality of life and psychological and social problems, including depression, anxiety, and a sense of helplessness and hopelessness. These patients require empathy, understanding and practical support to allow them to cope with their chronic bladder disorder.

Experience of using Neurouridine® in various types of peripheral neuropathy

2021 ◽  
Vol 7-8 (217-218) ◽  
pp. 29-36
Author(s):  
Nazira Zharkinbekova ◽  
◽  
Aiganym Khamidulina ◽  
Zhazira Barat ◽  
Botagoz Rustemova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Peripheral Neuropathy ◽  
Pain Assessment ◽  
Pain Syndrome ◽  
Symptomatic Therapy ◽  
Chronic Pain Syndrome ◽  
Combination Drug ◽  
Face Scale

The quality of life of patients with chronic pain syndrome remains one of the most pressing issues. Pain is considered chronic if it lasts or recurs for more than 3-6 months. This contributes to disability, depression, sleep disorders, poor quality of life, and what is important in this situation, the cost of treatment. According to statistics, the average prevalence of chronic pain in the adult population is 20%. Practitioners everywhere are in search of new methods of pain relief. Purpose of research. The quality of life of patients with chronic pain syndrome has traditionally remained a topical issue. Given the permanent nature of pain and the completeness of approaches to its relief, the modern Clinician is constantly looking for new treatment methods that meet the principles of evidence-based medicine and safety. Material and methods. This paper presents the results of using Neurouridine® in 30 patients with peripheral neuropathy. 30 patients were randomized for a 3-week treatment period. Average age: 47.5±1.5 years. All patients received standard symptomatic therapy, and an oral combination drug containing b vitamins, folic acid, choline, and Uridine was added to the treatment in the 150 mg mode once a day. Patients made three visits to the outpatient neurological office: visit 1-to evaluate pre-treatment, visit 2-after 10 days of treatment, and visit 3-after 20 days of treatment. Each patient was presented with two performance evaluations at each study visit: pain assessment on the CRS NRS scale, and the fps Face scale. Results and discussion. Analysis of the results of the treatment showed improvement in the form of reduced pain, improved quality of life in 65.90%, rapid recovery of performance in 32.10%, reduced need for analgesics in 59.90% and complete disappearance of symptoms in 25.30% of patients. Pain was assessed using the HI NRG scale, the AZA Face scale, and the frequency of analgesics at the patient's first, second, and third visits. Conclusion. The use of Neurouridine® for analgesic purposes has shown a positive effect on reducing symptoms in patients with peripheral neuropathy. The results confirm that this therapy provides a clear regeneration of the nerves, relieving pain, and reducing the soreness characteristic of nerve damage. Keyword: peripheral neuropathy, Neurouridine®, pain assessment, quality of life.

Influences of Suvorexant and Mirtazapine on Chronic Pain-related Sleep Disorder in Neuropathic Pain Model Mice 

2021 ◽  
Author(s):  
Hisakatsu Ito ◽  
Hiroshi Tusneki ◽  
Toshiyasu Sasaoka ◽  
Naoki Toyooka ◽  
Mitsuaki Yamazaki
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Sleep Disorders ◽  
Sleep Onset ◽  
Voluntary Activity ◽  
Pain Model ◽  
Neuropathic Pain Model ◽  
Pain State ◽  
Serotonergic Antidepressant

Abstract Chronic pain and sleep disorders are independently associated with a reduction in the quality of life. They can be both a cause and consequence of each other; therefore, they should be treated simultaneously. However, optimal treatments for chronic pain-related sleep disorders are not well established. Here, we aimed to investigate the effects of suvorexant, a novel sleep drug, and mirtazapine, a noradrenergic and specific serotonergic antidepressant, on pain-related sleep disorders in a preclinical neuropathic pain mouse model, which was produced by partial sciatic nerve ligation. We calculated the quantity, duration, and depth of sleep by analyzing the electroencephalogram. Voluntary activity was also evaluated by counting the number of wheel rotations with special cages. Daily administration of suvorexant and mirtazapine normalized the reduced rapid eye movement (REM) and non-REM sleep and improved the fragmented sleep, further regaining the depth of sleep at sleep onset in the chronic pain state. Suvorexant decreased voluntary activity, which was prolonged after the end of administration; however, mirtazapine did not decrease it. Both suvorexant and mirtazapine could be potential therapeutic agents for chronic pain-related sleep disorders.

Neuroimmune Interactions and Pain

2019 ◽  
pp. 363-387
Author(s):  
Jiahe Li ◽  
Peter M. Grace
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Nerve Injury ◽  
Purinergic Receptors ◽  
Critical Role ◽  
Oxygen Species ◽  
Neuroimmune Interactions ◽  
Sphingosine 1 Phosphate ◽  
Necrosis Factor

Chronic pain imposes a tremendous burden on the sufferer’s quality of life. Mounting evidence supports a critical role for neuroimmune interactions in the development and maintenance of chronic pain. Nerve injury leads to the activation of glia via sphingosine-1-phosphate, Toll-like receptors, chemokines, neuropeptides, and purinergic receptors. In turn, activated glia influence neuronal activity via interleukin 1β, tumor necrosis factor, brain-derived neurotrophic factor, reactive oxygen species, and excitatory amino acids. Epigenetic mechanisms of neuroimmune communication are also discussed. Investigation of neuroimmune interactions after peripheral nerve injury broadens our understanding of the mechanisms that drive neuropathic pain, and such interactions provide potential therapeutic targets for managing neuropathic pain.

scholarly journals Effect of preoperative gabapentin on pain intensity and development of chronic pain after carpal tunnel syndrome surgical treatment in women: randomized, double-blind, placebo-controlled study

2016 ◽  
Vol 134 (4) ◽  
pp. 285-291 ◽  
Author(s):  
Eduardo Jun Sadatsune ◽  
Plínio da Cunha Leal ◽  
Rachel Jorge Dino Cossetti ◽  
Rioko Kimiko Sakata
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Surgical Treatment ◽  
Postoperative Pain ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Postoperative Analgesia ◽  
Pain Syndrome ◽  
Double Blind ◽  
Tunnel Syndrome

ABSTRACT CONTEXT AND OBJECTIVES: Effective postoperative analgesia is important for reducing the incidence of chronic pain. This study evaluated the effect of preoperative gabapentin on postoperative analgesia and the incidence of chronic pain among patients undergoing carpal tunnel syndrome surgical treatment. DESIGN AND SETTINGS: Randomized, double-blind controlled trial, Federal University of São Paulo Pain Clinic. METHODS: Forty patients aged 18 years or over were randomized into two groups: Gabapentin Group received 600 mg of gabapentin preoperatively, one hour prior to surgery, and Control Group received placebo. All the patients received intravenous regional anesthesia comprising 1% lidocaine. Midazolam was used for sedation if needed. Paracetamol was administered for postoperative analgesia as needed. Codeine was used additionally if the paracetamol was insufficient. The following were evaluated: postoperative pain intensity (over a six-month period), incidence of postoperative neuropathic pain (over a six-month period), need for intraoperative sedation, and use of postoperative paracetamol and codeine. The presence of neuropathic pain was established using the DN4 (Douleur Neuropathique 4) questionnaire. Complex regional pain syndrome was diagnosed using the Budapest questionnaire. RESULTS: No differences in the need for sedation, control over postoperative pain or incidence of chronic pain syndromes (neuropathic or complex regional pain syndrome) were observed. No differences in postoperative paracetamol and codeine consumption were observed. CONCLUSIONS: Preoperative gabapentin (600 mg) did not improve postoperative pain control, and did not reduce the incidence of chronic pain among patients undergoing carpal tunnel syndrome surgery.

Chronic Pain After Lung Resection: Risk Factors, Neuropathic Pain, and Quality of Life

2020 ◽  
Vol 60 (2) ◽  
pp. 326-335 ◽  
Author(s):  
Silvia Fiorelli ◽  
Luigi Cioffi ◽  
Cecilia Menna ◽  
Mohsen Ibrahim ◽  
Roberto A. De Blasi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Lung Resection

Metabolic Therapy and Pain

2016 ◽  
Author(s):  
David N. Ruskin
Keyword(s):  
Chronic Pain ◽  
Pain Syndrome ◽  
Poor Quality ◽  
Fatty Acid Supplementation ◽  
Pain Syndromes ◽  
Drug Treatments ◽  
Dietary Treatments ◽  
Dietary Modifications ◽  
Chronic Pain Syndromes

Chronic pain is associated strongly with poor quality of life. Drug treatments for pain can be problematic; with the understanding that chronic pain syndromes often involve derangement of homeostasis, there is an increased interest in applying nonpharmacological metabolic therapies. This chapter surveys clinical and animal research into the effects of fasting, calorie restriction, ketogenic diet, and polyunsaturated fatty acid supplementation on pain. These dietary treatments can significantly ameliorate pain in inflammatory and neuropathic disorders. The choice among these treatments might depend on the specific pain syndrome and the tolerance of the patient for particular dietary modifications. Several possible mechanisms are discussed, some of which might be in common among these treatments, and some treatments might engage multiple mechanisms. Multiple mechanisms acting together could be ideal for restoring the disordered metabolism underlying some pain syndromes.

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