Medikamentöse Behandlungsstrategien bei chronischen Schmerzen

Chronische Schmerzen treten europaweit mit einer Punktpravalenz von etwa 20% haufig auf. Bei ihrer Entstehung spielen somatische, psychologische und soziale Faktoren in gleichberechtigter Verwobenheit eine bedeutsame Rolle. Aus diesem Grund ist eine sorgfaltige Evaluation des Zusammenspiels dieser Faktoren der entscheidende Schritt fur eine erfolgreiche Therapie. Neue Erkenntnisse uber pathophysiologische Vorgange, die mit chronischen Schmerzen assoziiert sind, haben zu einer zunehmenden Ausdifferenzierung medikamentoser und nichtmedikamentoser Strategien gefuhrt, die individuelle Faktoren berucksichtigen und auf die Beeinflussung des neuronalen Netzwerkes abzielen, in dem die chronischen Schmerzen codiert sind. Die dabei eingesetzten Medikamente werden nach pathophysiologischen Erkenntnissen und spezifischen Medikamentenwirkungen ausgesucht und oft auch in Kombination gegeben. Das Wissen uber antihyperalgetisch wirksame Medikamente wie Antidepressiva und Antikonvulsiva nimmt bestandig zu und soll daher in vorliegender Arbeit genauer vorgestellt werden.

[1]  T. Tölle,et al.  Duloxetine use in chronic painful conditions – individual patient data responder analysis , 2013, European journal of pain.

[2]  Ronald S Duman,et al.  New paradigms for treatment‐resistant depression , 2013, Annals of the New York Academy of Sciences.

[3]  M. Schuers,et al.  Evidence of prescription of antidepressants for non-psychiatric conditions in primary care: an analysis of guidelines and systematic reviews , 2013, BMC Family Practice.

[4]  H. Göbel.  [Innovative integrated and coordinated care in pain therapy]. , 2013, Schmerz.

[5]  C. Argoff.  Topical analgesics in the management of acute and chronic pain. , 2013, Mayo Clinic proceedings.

[6]  H. Gerbershagen.  [Transition from acute to chronic postsurgical pain. Physiology, risk factors and prevention]. , 2013, Schmerz.

[7]  M. Karst,et al.  Ca++/CaMKII switches nociceptor‐sensitizing stimuli into desensitizing stimuli , 2012, Journal of neurochemistry.

[8]  A. Dahan,et al.  Pharmacokinetic and pharmacodynamic considerations for NMDA receptor antagonists in the treatment of chronic neuropathic pain , 2012, Expert opinion on drug metabolism & toxicology.

[9]  E. Tam,et al.  Transdermal Lidocaine and Ketamine for Neuropathic Pain: A Study of Effectiveness and Tolerability , 2012, The open neurology journal.

[10]  W. Häuser,et al.  [Definition, diagnosis and therapy of chronic widespread pain and so-called fibromyalgia syndrome in children and adolescents. Systematic literature review and guideline]. , 2012, Schmerz.

[11]  B. Orser,et al.  The Prevention of Chronic Postsurgical Pain Using Gabapentin and Pregabalin: A Combined Systematic Review and Meta-Analysis , 2012, Anesthesia and analgesia.

[12]  E. Kalso,et al.  A new definition of neuropathic pain , 2011, PAIN®.

[13]  C. Woolf.  Central sensitization: Implications for the diagnosis and treatment of pain , 2011, PAIN.

[14]  George Kollias,et al.  Blockade of TNF-α rapidly inhibits pain responses in the central nervous system , 2011, Proceedings of the National Academy of Sciences.

[15]  P. Langley,et al.  The prevalence, correlates and treatment of pain in the European Union , 2011, Current medical research and opinion.

[16]  P. Langley,et al.  The impact of pain on labor force participation, absenteeism and presenteeism in the European Union , 2010, Journal of medical economics.

[17]  A. Serretti,et al.  Antidepressants and body weight: a comprehensive review and meta-analysis. , 2010, The Journal of clinical psychiatry.

[18]  T. Jensen,et al.  The evidence for pharmacological treatment of neuropathic pain , 2010, PAIN.

[19]  B. Nagel,et al.  Effektivität intensiver multimodaler Schmerztherapie-Programme , 2010, Der Schmerz.

[20]  D. Silove,et al.  A Study of the Protective Function of Acute Morphine Administration on Subsequent Posttraumatic Stress Disorder , 2009, Biological Psychiatry.

[21]  R. Sansone,et al.  Pain, pain, go away: antidepressants and pain management. , 2008, Psychiatry (Edgmont (Pa. : Township)).

[22]  R. Hargreaves,et al.  Advances in the pharmacologic treatment of tension-type headache , 2008, Current pain and headache reports.

[23]  P. Moayyedi,et al.  Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis , 2008, Gut.

[24]  G. McCleane.  Antidepressants as Analgesics , 2008, CNS drugs.

[25]  H. Diener,et al.  Akuttherapie und Prophylaxe der Migräne , 2008, Nervenheilkunde.

[26]  G. Spielmans.  Duloxetine Does Not Relieve Painful Physical Symptoms in Depression: A Meta-Analysis , 2007, Psychotherapy and Psychosomatics.

[27]  J. Farrar,et al.  Pharmacologic management of neuropathic pain: Evidence-based recommendations , 2007, PAIN.

[28]  M. Stein,et al.  Pain in the aftermath of trauma is a risk factor for post-traumatic stress disorder , 2007, Psychological Medicine.

[29]  M. Greaves.  Recent advances in pathophysiology and current management of itch. , 2007, Annals of the Academy of Medicine, Singapore.

[30]  Peter Henningsen,et al.  Management of functional somatic syndromes , 2007, The Lancet.

[31]  R. Kerns,et al.  Meta-analysis of psychological interventions for chronic low back pain. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[32]  K. Demyttenaere,et al.  The association of depression and painful physical symptoms–a review of the European literature , 2006, European Psychiatry.

[33]  M. Sise,et al.  Long-term posttraumatic stress disorder persists after major trauma in adolescents: new data on risk factors and functional outcome. , 2005, The Journal of trauma.

[34]  W. Häuser,et al.  Funktionelle somatische Schmerzsyndrome , 2004, Der Schmerz.

[35]  S. E. Stewart,et al.  Which SSRI? A meta-analysis of pharmacotherapy trials in pediatric obsessive-compulsive disorder. , 2003, The American journal of psychiatry.

[36]  R. Pabst,et al.  Postnatally induced differences in adult pain sensitivity depend on genetics, gender and specific experiences: reversal of maternal deprivation effects by additional postnatal tactile stimulation or chronic imipramine treatment , 2002, Behavioural Brain Research.

[37]  S. Schreiber,et al.  Venlafaxine and mirtazapine: different mechanisms of antidepressant action, common opioid-mediated antinociceptive effects--a possible opioid involvement in severe depression? , 2002, Journal of molecular neuroscience : MN.