Serotonine-noradrenalineheropnameremmers bij chronische niet-maligne pijnsyndromen; een systematisch overzicht

BACKGROUND: Chronic pain and depressive symptoms are often comorbid. Antidepressants seem to influence not only the symptoms of depression but also the perception of pain. AIM: To give a systematic overview of the efficacy and safety of serotonin-noradrenalin reuptake inhibitors (SNRI) in the treatment of chronic non-malignant pain syndromes. METHODS: We reviewed the literature by means of PubMed and PsycInfo using combinations of the words 'pain' 'venlafaxine' and 'duloxetine'. We selected clinical studies that investigated the influence of SNRIS on pain perception. RESULTS: Fourteen articles met our selection criteria. Medical conditions involved were fibromyalgia, diabetic neuropathy and post mastectomy pain. Twelve studies demonstrated the efficacy and safety of venlafaxine and duloxetine in the treatment of non-malignant pain. CONCLUSION: The results revealed that SNRIs are effective in reducing pain particularly in the treatment of diabetic neuropathy. Results with regard to the other medical conditions are less clear. More research is needed to find out in which medical conditions SNRIs have a significant pain reducing effect and why this effect does not hold in the case of other medical conditions.