Utilizing Milnacipran for Improving QOL of Case with Neuropathic Pain : SNRI as Algetic Adjuvant

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  • MilnacipranによりQOLの改善をみた慢性疼痛の事例 : 鎮痛補助剤としてのSNRIの有用性について
  • 症例研究 MilnacipranによりQOLの改善をみた慢性疼痛の事例--鎮痛補助剤としてのSNRIの有用性について
  • ショウレイ ケンキュウ Milnacipran ニ ヨリ QOL ノ カイゼン オ ミタ マンセイ トウツウ ノ ジレイ チンツウ ホジョザイ ト シテノ SNRI ノ ユウヨウセイ ニ ツイテ

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Abstract

Neuropathic pain (NP) is a bother to both patient and doctor, related to severity, chronicity and resistance to licensed analgesics. It damages the quality of life (QOL) of people with NP and the relationship with their therapists. Author reported 3 elder female cases whose lower QOL caused by NP improved with its remission, using milnacipran, which is the only serotonin norepinephrine reuptake inhibitor (SNRI) in Japan and recognized as safer than tricyclic antidepressants. Possible antinociceptive mechanisms of them include direct effect, activation of descending inhibition pain system and, psychosomatic which is effect considered as main effect by most clinicians in Japan. There are lots of reports indicating antidepressants as the gold standard treatment for NP, suggesting that SNRIs may work as analgesics, independent of antidepressants. These cases indicated that primary care physicians as well as psychiatrists must recognize the analgesic efficacy of milnacipran and facilitate to use it in daily practice also in Japan, and it may significantly improve QOL of people with NP, especially elderly.

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