만성통증 환자에서 항우울제의 사용
Consideration of Antidepressants in Patients with Chronic Pain
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Abstract
Antidepressant pharmacotherapy presents many challenges to clinicians dealing with patients suffering from chronic pain. Depression in patients with more pain is associated with pain complaints and greater impairments. Depression and pain share a biological pathway and neurotransmitters, which have implications for their concurrent treatments. Treated in isolation, each of these conditions can prove difficult to treat. Collectively, depression and pain often present significantly greater challenges to the clinician. Antidepressants may be used as a primary treatment modality for depression in a patient dealing with chronic pain, at other times, these agents may be used to treat certain specific chronic pain syndromes, possibly in the face of concomitant depression. Clinicians should be aware of the many peculiarities associated with this broad class of medications. Included in this review are considerations for drug selection, dose escalation and common drug related problems (e.g., adverse drug reactions). In addition, attention has been paid to the appropriate selection of an agent for use in the primary management of either pain or depression.
참고문헌 (20)
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