Robinson Christopher, Dalal Suhani, Chitneni Ahish, Patil Anand, Berger Amnon A, Mahmood Syed, Orhurhu Vwaire, Kaye Alan D, Hasoon Jamal
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School.
Department of Internal Medicine, Loma Linda University.
Health Psychol Res. 2022 May 30;10(3):32309. doi: 10.52965/001c.32309. eCollection 2022.
Chronic pain continues to be one of the leading healthcare cost burdens in the United States and is typically defined as ongoing pain, lasting longer than six months. Various treatment options exist for chronic pain, including physical therapy, medical management, pain psychology, and interventional therapies. Pain medications have been the mainstay of treatment for chronic pain conditions with an increasing use of membrane stabilizers and antidepressants to treat neuropathic pain conditions. Specifically, serotonin noradrenaline reuptake inhibitors (SNRIs) have been used to treat a range of pain conditions expanding from everyday use for depressive disorders.
SNRIs, including duloxetine, venlafaxine, and milnacipran, have demonstrated efficacy in reducing pain in musculoskeletal pain (chronic low back pain and osteoarthritis), fibromyalgia, and neuropathic pain conditions (peripheral diabetic neuropathy).
The article describes the function, role, and use of SNRIs to treat chronic and neuropathic pain by altering the noradrenergic descending inhibitory pathways.
慢性疼痛仍是美国主要的医疗费用负担之一，通常被定义为持续时间超过六个月的持续性疼痛。慢性疼痛有多种治疗选择，包括物理治疗、药物治疗、疼痛心理学和介入治疗。止痛药物一直是慢性疼痛治疗的主要手段，越来越多地使用膜稳定剂和抗抑郁药来治疗神经性疼痛。具体而言，5-羟色胺去甲肾上腺素再摄取抑制剂（SNRIs）已被用于治疗一系列疼痛病症，其应用范围已从日常用于治疗抑郁症扩展而来。
包括度洛西汀、文拉法辛和米那普明在内的SNRIs已证明在减轻肌肉骨骼疼痛（慢性腰痛和骨关节炎）、纤维肌痛和神经性疼痛（糖尿病性周围神经病变）方面有效。
本文介绍了SNRIs通过改变去甲肾上腺素能下行抑制通路来治疗慢性疼痛和神经性疼痛的功能、作用及应用。
