Patient with pain and depression – practical therapeutic implications

Ból ◽  
2021 ◽  
Vol 22 (2) ◽  
pp. 33-41
Author(s):  
Krzysztof Wojtasik-Bakalarz ◽  
Jarosław Woroń ◽  
Marcin Siwek ◽  
Anna Krupa
Keyword(s):  
Chronic Pain ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Effectiveness ◽  
Pain Syndrome ◽  
Therapeutic Implications ◽  
Noradrenaline Reuptake ◽  
Treatment Of Depression ◽  
The Relationship ◽  
Worse Prognosis

Depression and pain are often coexisting phenomena, and the relationship between both phenomena is two-way – the occurrence of depression increases the risk of pain, and both acute and chronic pain increase the risk of depression. Pain may be part of the clinical picture of depression, be a result of comorbid psychiatric disorders, be associated with comorbidities, be a chronic pain syndrome, or be a complication of pharmacotherapy. The comorbidity of pain and depression is associated with a worse prognosis, lower therapeutic response, lower quality of life, impaired functioning, and a greater risk of relapse and suicide. There are indications that the same structures and neurotransmitters are involved in the pathophysiology of pain and depression, which may explain the coanalgesic effect of some antidepressants. The drugs with the best proven effectiveness are serotonin and noradrenaline reuptake inhibitors (especially duloxetine) and amitriptyline. Other drugs that may be of use in the treatment of pain are mirtazapine, mianserin, trazodone, agolemelatine, bupropion, and moclobemide. Selective serotonin reuptake inhibitors are used primarily in the treatment of depression symptomatic pain, but there is little evidence that they are effective in other types of pain. The use of certain psychotropic drugs, incl. SSRIs, clomipramine, benzodiazepines, Z drugs, and anticholinergics may be associated with increased pain. Caution is required when using polypharmacy in the form of a combination of an antidepressant and an analgesic because of the risk of worsening side effects or loss of treatment effectiveness. In the case of opioid drugs, in particular tramadol, the combination with drugs with a serotonergic effect may be associated with the risk of serotonin syndrome.

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.

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.

The relationship between opioid usage and sleep quality in veterans with chronic pain syndrome

2009 ◽  
Vol 10 (4) ◽  
pp. S48
Author(s):  
L. Saxon ◽  
S. Sanders ◽  
M. Clark ◽  
R. Gironda
Keyword(s):  
Chronic Pain ◽  
Sleep Quality ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
The Relationship

scholarly journals Pharmacological interventions for people with depression and chronic physical health problems: systematic review and meta-analyses of safety and efficacy

2011 ◽  
Vol 198 (3) ◽  
pp. 179-188 ◽  
Author(s):  
David Taylor ◽  
Nicholas Meader ◽  
Victoria Bird ◽  
Steve Pilling ◽  
Francis Creed ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Physical Health ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Health Problems ◽  
Treatment Of Depression ◽  
First Choice ◽  
Physical Health Problems ◽  
Meta Analyses

BackgroundAntidepressant drugs are widely used in the treatment of depression in people with chronic physical health problems.AimsTo examine evidence related to efficacy, tolerability and safety of antidepressants for people with depression and with chronic physical health problems.MethodMeta-analyses of randomised controlled efficacy trials of antidepressants in depression in chronic physical health conditions. Systematic review of safety studies.ResultsSixty-three studies met inclusion criteria (5794 participants). In placebo-controlled studies, antidepressants showed a significant advantage in respect to remission and/or response: selective serotonin reuptake inhibitors (SSRIs) risk ratio (RR) = 0.81 (95% CI 0.73–0.91) for remission, RR = 0.83 (95% CI 0.71–0.97) for response; tricyclics RR = 0.70 (95% CI 0.40–1.25 (not significant)) for remission, RR = 0.55 (95% 0.43–0.70) for response. Both groups of drugs were less well tolerated than placebo (leaving study early due to adverse effects) for SSRIs RR = 1.80 (95% CI 1.16–2.78), for tricyclics RR = 2.00 (95% CI 0.99–3.57). Only SSRIs were shown to improve quality of life. Direct comparisons of SSRIs and tricyclics revealed no advantage for either group for remission, response, effect size or tolerability. Effectiveness studies suggest a neutral or beneficial effect on mortality for antidepressants in participants with recent myocardial infarction.ConclusionsAntidepressants are efficacious and safe in the treatment of depression occurring in the context of chronic physical health problems. The SSRIs are probably the antidepressants of first choice given their demonstrable effect on quality of life and their apparent safety in cardiovascular disease.

scholarly journals Pain catastrophizing, perceived injustice, and pain intensity impair life satisfaction through differential patterns of physical and psychological disruption

2017 ◽  
Vol 17 (1) ◽  
pp. 390-396 ◽  
Author(s):  
John A. Sturgeon ◽  
Maisa S. Ziadni ◽  
Zina Trost ◽  
Beth D. Darnall ◽  
Sean C. Mackey
Keyword(s):  
Chronic Pain ◽  
Life Satisfaction ◽  
Depressive Symptoms ◽  
Pain Intensity ◽  
Cognitive Appraisal ◽  
Pain Catastrophizing ◽  
Perceived Injustice ◽  
Appraisal Processes ◽  
The Relationship

AbstractBackground and purposePrevious research has highlighted the importance of cognitive appraisal processes in determining the nature and effectiveness of coping with chronic pain. Two of the key variables implicated in appraisal of pain are catastrophizing and perceived injustice, which exacerbate the severity of pain-related distress and increase the risk of long-term disability through maladaptive behavioural responses. However, to date, the influences of these phenomena have not been examined concurrently, nor have they been related specifically to quality of life measures, such as life satisfaction.MethodsUsing data froman online survey of330 individuals with chronic pain, structural path modelling techniques were used to examine the independent effects of pain catastrophizing, perceived injustice, and average pain intensity on life satisfaction. Two potential mediators of these relationships were examined: depressive symptoms and pain-related interference.ResultsResults indicated that depressive symptoms fully mediated the relationship between pain catastrophizing and life satisfaction, and pain interference fully mediated the relationship between pain intensity and life satisfaction. Both depressive symptoms and pain interference were found to significantly mediate the relationship between perceived injustice and life satisfaction, but perceived injustice continued to demonstrate a significant and negative relationship with life satisfaction, above and beyond the other study variables.ConclusionsThe current findings highlight the distinct affective and behavioural mediators of pain and maladaptive cognitive appraisal processes in chronic pain, and highlight their importance in both perceptions of pain-related interference and longer-term quality of life.

scholarly journals The relationship between chronic pain and health-related quality of life in long-term social assistance recipients in Norway

2010 ◽  
Vol 19 (10) ◽  
pp. 1457-1465 ◽  
Author(s):  
Borghild Løyland ◽  
Christine Miaskowski ◽  
Steven M. Paul ◽  
Espen Dahl ◽  
Tone Rustøen
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Social Assistance ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Relationship

scholarly journals Partial Androgen Deficiency, Depression, and Testosterone Supplementation in Aging Men

2012 ◽  
Vol 2012 ◽  
pp. 1-17 ◽  
Author(s):  
Mario Amore ◽  
Marco Innamorati ◽  
Sara Costi ◽  
Leo Sher ◽  
Paolo Girardi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Current Knowledge ◽  
Androgen Deficiency ◽  
Aging Male ◽  
Aged Patients ◽  
Treatment Of Depression ◽  
Aging Men ◽  
Potential Benefits ◽  
The Relationship

The aim of this review was to summarize current knowledge on the correlation between depressive symptoms with a syndrome called partial androgen deficiency of the aging male (PADAM) and on the potential benefits of testosterone (T) treatment on mood. Despite, the causative nature of the relationship between low T levels and depression is uncertain, many hypogonadal men suffer from depression and vice versa several depressed patients are affected by hypogonadism. Supplementation with testosterone failed to show sound evidence of effectiveness in the treatment of depression. Nevertheless, testosterone supplementation has proved to be effective on some domains significant for the quality of life of aged patients with PADAM (sexual function and cognitive functions, muscular strengths).

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