"Pain" to sadness, why pain patients, can use antidepressants.

Introduction: It is common for pain patients to take antidepressants.
is one of the most common clinical symptoms, and poor pain control can lead to dysfunction of the body's organ systems, compromised immune systems, and also lead to or accompanying depression, anxiety, and sleep disorders.
depression, also known as depression disorder, is characterized by significant and persistent depression.
is it justified to meet a physician who issues antidepressants to patients with pain, clinically, sometimes?" What is the link between pain and depression? How do antidepressants treat pain? Next, I'll find out for you all.
a very common relationship between depression and pain seems to be a two-way street.
reported that 30%-60% of people with depression have pain symptoms.
with chronic pain such as rheumatoid arthritis and systemic lupus erythematosus showed anxiety and depression as high as 93% and 94%.
depression, anxiety, chronic pain, sleep disorders, cognitive impairment and fatigue not only increase the difficulty of diagnosing the disease, but also increase the complexity of treatment.
addition, the relationship between pain and depression is not only manifested in high coexistence, they also promote each other, chronic pain is a strong predictor of subsequent depressive episodes, and vice versa.
recent developments in neuroscience and psychoimmune science, the underlying mechanisms of pain and depression, suggest that the high co-pathogenesicity of pain and depression may be driven by the same pathophysiological processes in the brain and body. the
study found that the occurrence of depression and genetic, psychological, neuroendocrine and other factors induced by the central 5-oxycodone (5-HT), dethyroidism (NE), dopamine, Ach and neurotransmitter content decreased and its recipient function decreased, and 5-HT, NE plays an important role in the lower pain regulation system (see left), its dysfunction makes the brain accept amplified pain signals, leading to pain perception.
Therefore, antidepressants acting on 5-HT and NE may treat depression by increasing 5-HT and NE in synactical gaps and playing a role in the downpathic pathways of pain transmission, blocking pain signals to the brain to treat neuropathic pain.
Antidepressants treat pain with both direct and indirect effects Previous studies have shown that antidepressants such as SNRIs (5-HT and NE reuptake inhibitors) represent a significant improvement in depression and pain symptoms in depressed patients, so is it the improvement of depressive symptoms that relieves pain or vice versa? A meta-analysis published in the journal PAIN in 2016 showed that dolositin had a time difference in the relief of depressive symptoms and pain symptoms, with a direct effect on the weakening of pain symptoms during its treatment (first week: 75.3 percent; eighth week: 22.6 percent), and indirect effects on pain symptoms decreased by improving depressive symptoms (first week: 24.7 percent; eighth week: 77.4 percent).
it is speculated that in the early stages of treatment, the dominant direct effect may be due to the involvement of the epinephrine pain regulation system, and with the extension of treatment time, its antidepressant mechanism plays an indirect role.
showed that 5-HT and NE reuptake inhibitors were not only associated with depression relief, but also by the regulation of the down-path of pain transmission.
antidepressants that are commonly used to treat pain are not suitable for pain patients due to the different mechanisms of antidepressants, and the dosages of pain and depression are treated differently.
domestic and foreign guidelines recommend antidepressants for pain treatment are: (1) tricetam antidepressants (TCAs) are most commonly used for amitisin, deatrophine.
(2) SNRIs: Common drugs include venlafasin and dolositin.
Specific dosages and precautions are shown in the table below: Conclusions are not uncommon for the treatment of pain with antidepressants clinically, but it is worth noting that both the initial dose and the maintenance dose are smaller than those used for antidepressants, and adverse drug reactions are often avoidable and toned in the case of regulatory applications.
But considering that pain patients take more combination drugs, and more basic diseases, in practice, should be fully assessed, weighing the pros and cons, and from a small dose, gradually adjust.
for patients, with the treatment of medical staff, "follow the doctor's instructions" can be.
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