Psychiatria pre prax 3/2009

Complex antidepressant effect and pain

Pain and depression are pathological states influenced by serotonergic and noradrenergic system functioning. In the treatment of both states are used drugs, affecting both neurotransmitter systems. In the chronic pain pathogenesis besides neuronal system changes takes place also glial cell activation, which can endure acute pain stimulus and participate in the pain chronification. Antidepressant treatment is affecting depressive syndrome and pain affective and cognitive component due neuroplastic processes modulation. Inflammatory mediators can activate stress axis and influence neurotransmitter metabolism during chronic pain states, antidepressants diminish inflammatory molecule production on the periphery and in the central nervous system, uncoupling thus stress axis activation.

Keywords: pain, depression, antidepressant, microglia, astrocyte, cytokine, neuroplasticity