France R D
Duke University Medical Center, Durham, N.C.
Psychopathology. 1987;20 Suppl 1:99-113. doi: 10.1159/000284529.
Antidepressant drugs have been used successfully in the treatment of chronic pain syndromes. Clinical trials have supported the use of these drugs for pain and the depression that often accompanies pain syndromes. Although the exact mechanisms of action have not been clearly elucidated, it has been suggested that these agents have analgesic properties independent of their antidepressant effect on mood and behavior. Pain patients without concomitant depression experienced pain relief with antidepressant therapy; these patients represent the most convincing evidence that antidepressant drugs have a direct analgesic effect. Studies presented in this paper support the clinical efficacy of antidepressant medications in the treatment of patients suffering from headaches (migraine, tension, and mixed types), diabetic neuropathy, arthritis, and facial pain. These data also suggest that antidepressant drugs may be effective in the treatment of postherpetic neuralgia, back pain, and pain from mixed etiologies; however, data for these pain syndromes are less clear, and, thus, further testing is required.
抗抑郁药物已成功用于治疗慢性疼痛综合征。临床试验支持使用这些药物治疗疼痛以及常伴随疼痛综合征出现的抑郁症。尽管确切的作用机制尚未完全阐明，但有人提出这些药物具有镇痛特性，独立于其对情绪和行为的抗抑郁作用。没有合并抑郁症的疼痛患者通过抗抑郁治疗获得了疼痛缓解；这些患者是抗抑郁药物具有直接镇痛作用的最有说服力的证据。本文所呈现的研究支持抗抑郁药物在治疗头痛（偏头痛、紧张性头痛和混合型头痛）、糖尿病性神经病变、关节炎和面部疼痛患者方面的临床疗效。这些数据还表明，抗抑郁药物可能对治疗带状疱疹后神经痛、背痛和多种病因引起的疼痛有效；然而，这些疼痛综合征的数据尚不太明确，因此需要进一步测试。
