Pathogenetic mechanisms of antinociceptive activity of antidepressants

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  • Authors: Scheidegger J.M.1, Dorovskiкh I.V.2, Pavlova T.A.2
  • Affiliations:
    1. «Национальный медицинский исследовательский центр психиатрии и наркологии имени В.П. Сербского» Министерства здравоохранения Российской Федерации
    2. Федеральное государственное казенное учреждение «1586 Военный клинический госпиталь» Министерства обороны Российской Федерации
  • Issue: Vol 2, No 2 (2020)
  • Pages: 70-83
  • Section: Biomedical Sciences
  • URL: https://journals.eco-vector.com/PharmForm/article/view/34802
  • DOI: https://doi.org/10.17816/phf34802
  • ID: 34802


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Abstract

The article attempts to generalize the currently known pathogenetic mechanisms of antinociceptive effects of the most widely used antidepressants and to highlight the currently available data of experimental models of various pain disorders in laboratory animals and the results of clinical studies both in groups of patients with comorbid
pain symptoms and in patients with pain symptoms of various origins without the presence of pronounced affective disorders. The article presents the results of evidence-based studies of the analgesic activity of tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRI), selective serotonin and norepinephrine reuptake inhibitors (SNRI) and drugs with a special receptor mechanism of action. The involvement of various neurotransmitters: serotonin, dopamine, norepinephrine, melatonin, enkephalin, GABA, glutamate, adenosine, etc. in the implementation of the analgesic effect of antidepressants has been examined. The most common side effects of mentioned antidepressants of frequent cause of patients refusing treatment were highlighted as well. Taking into account the considered features of the treatment of comorbid patients with pain, recommendations on the choice of the drug not only according to the severity of its antidepressant and antinociceptive actions, but also the possible development of undesirable effects of long-term therapy were made. New groups of antidepressants with an alternative mechanism of action deserve special attention.

About the authors

Julia M. Scheidegger

«Национальный медицинский исследовательский центр психиатрии и наркологии имени В.П. Сербского» Министерства здравоохранения Российской Федерации

Email: Scheidegger.julia@gmail.com
Russian Federation

Igor V. Dorovskiкh

Федеральное государственное казенное учреждение «1586 Военный клинический госпиталь» Министерства обороны Российской Федерации

Author for correspondence.
Email: ig.dorovskikh@yandex.ru
Russian Federation

Tatyana A. Pavlova

Федеральное государственное казенное учреждение «1586 Военный клинический госпиталь» Министерства обороны Российской Федерации

Email: Pava-6@yandex.ru

Врач-психиатр

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