Pain medicine : the official journal of the American Academy of Pain Medicine
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OBJECTIVE. Explore the relationships between pain, depression, and functional disability in elderly persons. ⋯ While both pain and depression level affect physical performance, depressive symptoms rather than pain appear the more influential factor. When seeing elderly patients, identifying, evaluating, and treating both pain complaints and depressive symptoms and disorders may reduce functional impairment.
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Randomized Controlled Trial Clinical Trial
Palliative pharmaceutical care: a randomized, prospective study of telephone-based prescription and medication counseling services for treating chronic pain.
To evaluate the effects of providing a unique telephone-based pharmaceutical care program to a sample of patients enrolled at a university pain clinic in Philadelphia, Pa. We hypothesized that in comparison to routine pharmaceutical care, the telephone-based pharmaceutical care program would have a positive impact on delivery of medication, quality of life, and overall satisfaction with the pain clinic program. ⋯ This study suggests that the palliative-trained pharmacist can play an important collaborative role in managing chronic pain. Application of the pharmaceutical care model in pain medicine centers can improve satisfaction and remove some of the barriers to good pharmaceutical care facing patients with chronic pain disorders
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It has been hypothesized that serotonin reuptake inhibitor antidepressants (ADs) are only weakly antinociceptive but augment noradrenergic (NA) antinociception. Thus, ADs with combined serotonergic (SN) and NA activity, (i.e., the serotonergic/noradrenergic (SN/NA) ADs) should have greater antinociceptive activity versus the NA ADs, which in turn should have more antinociceptive activity than the SN ADs. The objective of this structured review was to test this hypothesis by reviewing relevant basic science literature on the treatment of experimental pain with the above different types of ADs. DESIGN, SETTING, PARTICIPANTS, OUTCOME, MEASURES: Animal or human experimental AD pain treatment studies were located by the usual search methods. For animal studies only placebo-controlled studies were included for review. For human studies only double blind placebo-controlled studies were selected for review. The animal and human studies were then sorted according to the pain model represented, e.g., neuropathic pain model. Studies were then characterized according to the type of AD utilized, and the antinociceptive outcome of the AD trial. ⋯ Overall, the results of this structured review support the above hypothesis.
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Immune responses are an input source of modulation/modification for the peripheral nervous system that can result in pain and/or peripheral neuropathy. The resulting pain can be a significant debilitating component of many diseases as well as an untoward side effect of treatment. This paper briefly describes three sources of peripheral neuropathy generated in the presence of, or associated with, an immune response. ⋯ The body, in an attempt to rid itself of a tumor or an invading bacterial infection or virus, attacks its nervous system due to molecular mimicry; this results in, respectively, paraneoplastic neuropathy or inflammatory polyneuropathy. The third neuropathic pain syndrome is iatrogenic and occurs after administration of an antibody to GD2 ganglioside as an immunotherapy for neuroblastoma. This paper will attempt to point out some common elements in their neuropathologies and mechanisms.