Antidepresivos, dolor y cáncer

Psicooncología, 2006
Source: OAI

ABSTRACT Existe una relación entre estrés, depresión y dolor, relación que es más evidente en los pacientes oncológicos. Teniendo en cuenta la eficacia de los antidepresivos en el tratamiento de ciertos tipos de dolor crónico y la elevada prevalencia de cuadros depresivos en pacientes oncológicos, consideramos interesante revisar las características del dolor crónico, especial¬mente en estos pacientes, y la relación entre dolor, cáncer y depresión. Por otra parte, la depresión y dolor tienen unas vías comunes que explicarían el mecanismo analgésico de los antidepresivos. Sin embargo, en clínica, la acción antidepresiva y la analgésica son total¬mente independientes. En el dolor crónico los antidepresivos más eficaces son los tricíclicos, pero debido a sus efectos indeseables se está tendiendo al uso de los nuevos antidepresivos duales como la venlafaxina y duloxetina. There is a close relationship between stress, depression, and pain, especially in cancer pa¬tients. As the efficacy of antidepressants in some types of chronic pain is well documented and the prevalence of depression is very high in cancer patients, we will review the main features of chronic pain, chronic pain in can¬cer, and the relationship between pain, can¬cer, and depression. Depression and pain have common pathways mediating the therapeutic effects of most currently available antidepres¬sants. Clinically, the effect of antidepressants on pain and on affective symptoms is indepen¬dent. In terms of efficacy, tricyclic antidepres¬sants tend to work better but their side effect profile favor the use of the new dual reuptake inhibitors as venlafaxine or duloxetine.

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