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文拉法辛治疗神经病理性疼痛的系统评价。

Treatment of Neuropathic Pain with Venlafaxine: A Systematic Review.

机构信息

Departments of Psychiatry.

Department of Anesthesiology, Family Medicine, and Pharmacology, Rush Medical College, North Shore University Health System Pain Centers Evanston and Skokie Hospital, Skokie, Illinois, USA.

出版信息

Pain Med. 2017 Oct 1;18(10):1999-2012. doi: 10.1093/pm/pnw261.

Abstract

OBJECTIVE

To investigate the efficacy of venlafaxine for neuropathic pain and review literature to determine if the medication provides adequate neuropathic pain relief.

METHODS

Literature was reviewed on MEDLINE using various key words. These key words include: "venlafaxine and pain," "venlafaxine ER and pain," "venlafaxine XR and pain," "venlafaxine and neuropathic pain," "venlafaxine and neuropathy," "SSRI and neuropathic pain," "SSRI and neuropathy," "SNRI and neuropathic pain," "SNRI and neuropathy," "serotonin reuptake inhibitor and neuropathic pain," "serotonin reuptake inhibitor and neuropathy," "serotonin norepinephrine reuptake inhibitor and neuropathic pain" and "serotonin norepinephrine reuptake inhibitor and neuropathy." Using this guideline, 13 articles were reviewed.

RESULTS

A total of 13 studies reviewed, which are organized by date and diagnosis. It is evident that in the majority of studies, when compared with a placebo, there was a clinical significant reduction in neuropathic pain relief when using venlafaxine. Additionally, one study showed even more significant pain relief when using higher doses of venlafaxine (at least 150 mg). However, when compared with alternative neuropathic medications, venlafaxine for the most part did not perform any better in terms of efficacy.

CONCLUSION

In conclusion, venlafaxine is a safe and well-tolerated analgesic drug for the symptomatic treatment of neuropathic pain, and there is limited evidence that high-dose venlafaxine (150 mg/day) can be even more beneficial. While the present evidence is quite encouraging regarding venlafaxine's use for neuropathic pain, further research is needed to continue to expand on these findings, particularly when in consideration with other possible pharmacological agents.

摘要

目的

研究文拉法辛治疗神经性疼痛的疗效,并查阅文献以确定该药是否能有效缓解神经性疼痛。

方法

在 MEDLINE 上使用各种关键词检索文献,这些关键词包括:“文拉法辛和疼痛”、“文拉法辛 ER 和疼痛”、“文拉法辛 XR 和疼痛”、“文拉法辛和神经性疼痛”、“文拉法辛和神经病变”、“SSRI 和神经性疼痛”、“SSRI 和神经病变”、“SNRI 和神经性疼痛”、“SNRI 和神经病变”、“选择性 5-羟色胺再摄取抑制剂和神经性疼痛”、“选择性 5-羟色胺再摄取抑制剂和神经病变”、“选择性 5-羟色胺-去甲肾上腺素再摄取抑制剂和神经性疼痛”和“选择性 5-羟色胺-去甲肾上腺素再摄取抑制剂和神经病变”。根据该指南,共回顾了 13 篇文章。

结果

共回顾了 13 项研究,按日期和诊断进行了分类。结果表明,在大多数研究中,与安慰剂相比,使用文拉法辛治疗神经性疼痛时,临床疼痛缓解有显著改善。此外,一项研究显示,使用更高剂量的文拉法辛(至少 150mg)时,疼痛缓解更为显著。然而,与其他神经性药物相比,文拉法辛在疗效方面并没有更好的表现。

结论

文拉法辛是一种安全且耐受良好的镇痛药物,可用于治疗神经性疼痛的症状,有有限的证据表明高剂量文拉法辛(150mg/天)可能更有益。虽然目前的证据表明文拉法辛治疗神经性疼痛的效果相当令人鼓舞,但仍需要进一步研究以继续扩展这些发现,特别是在考虑其他可能的药物治疗时。

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