治疗慢性疼痛的非阿片类精神药物:系统审查和元分析
Shahana Ayub1, Anil Krishna Bachu2, Lakshit Jain3
1Department of Psychiatry, The Institute of Living, Hartford, CT, United States.
Frontiers in pain research (Lausanne, Switzerland)
|October 25, 2024
概括
某些精神药物,如杜洛西丁和米罗加巴林,对纤维肌痛疼痛有短期的益处. 然而,这些药物对神经病痛或慢性腰部疼痛无效,没有观察到长期益处.
科学领域:
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
- 精神病学是一个精神病学.
背景情况:
- 阿片类药物危机需要非阿片类药物疼痛管理策略.
- 慢性疼痛经常与精神病相关疾病同时发生.
- 心理药物可以治疗精神症状和疼痛.
研究的目的:
- 系统地审查和元分析精神病药物治疗慢性疼痛的疗效.
- 评估纤维肌痛,神经病痛和慢性腰部疼痛的治疗方法.
- 评估短期和长期的有效性.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析,截至2023年2月.
- 包括患有慢性疼痛的18岁以上门诊患者,评估杜洛西丁,米罗加巴林,普雷加巴林, gabapentin 和TCA (包括SNRIs).
- 主要结果:减轻疼痛,改善功能,提高生活质量;按疼痛类型和持续时间分层.
主要成果:
- 在所有研究中都有显著的短期干预效应 (SMD-1.45).
- 杜洛西丁和米罗加巴林在纤维肌痛方面显示出相当大的疗效 (SMD -2.42和-2.10).
- 对于神经病痛或慢性腰部疼痛没有显著的益处; gabapentin 疗效未确定; 没有一致的长期益处.
结论:
- 杜洛西丁和米罗加巴林等精神病药物可为纤维肌痛提供短期缓解.
- 对神经病痛和慢性腰部疼痛的疗效没有统计学意义.
- 需要进一步的研究来澄清这些药物在特定慢性疼痛疾病中的作用,特别是长期使用.
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