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Antidepressants in cancer pain
A E Panerai1, M Bianchi, P Sacerdote
1Department of Pharmacology, School of Medicine, University of Milan, Italy.
Journal of Palliative Care
|January 1, 1991
Summary
Tricyclic antidepressants offer pain relief for cancer patients, independent of mood effects. They are particularly effective for neuropathic pain and may enhance opioid analgesia through intrinsic effects, not altered bioavailability.
Area of Science:
- Pharmacology
- Oncology
- Pain Management
Background:
- Antidepressant drugs are increasingly recognized for their role in managing cancer pain.
- Their pain-relieving effects appear distinct from their impact on mood or depression.
Purpose of the Study:
- To elucidate the role of antidepressant drugs in cancer pain management.
- To understand the mechanism of analgesic action and potential synergy with opioids.
Main Methods:
- Review of recent studies on antidepressant drug efficacy in cancer pain.
- Analysis of the pharmacological mechanisms underlying antinociception.
- Evaluation of interactions between antidepressants and opioid analgesics.
Main Results:
- Tricyclic antidepressants demonstrate significant analgesic effects, especially for neuropathic cancer pain.
- The antinociceptive action is independent of antidepressant effects on mood.
- Co-administration with opioids may potentiate analgesia via intrinsic antidepressant effects, not altered morphine bioavailability.
Conclusions:
- Tricyclic antidepressants are valuable in cancer pain management, particularly for neuropathic pain.
- Combination therapy with opioids is beneficial when deafferentation or depressive symptoms are present.