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      Venlafaxina en el tratamiento del dolor neuropático Translated title: Venlafaxine in the treatment of neuropathic pain

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          Abstract

          RESUMEN Introducción: La venlafaxina fue el primer antidepresivo inhibidor de la recaptación de serotonina y noradrenalina autorizado en España. Aunque no tiene indicación en ficha técnica en el tratamiento del dolor neuropático, hay guías de práctica clínica en las que la venlafaxina aparece en primera o segunda línea de tratamiento. Desarrollo: Tras una búsqueda bibliográfica, en este artículo se resumen los datos farmacológicos más relevantes de la venlafaxina, así como la bibliografía específica de este fármaco en dolor neuropático. Conclusiones: La venlafaxina es un fármaco seguro y bien tolerado para el tratamiento sintomático del dolor neuropático. Aunque la evidencia actual es bastante alentadora (en dosis de al menos 150 mg/día), son necesarias nuevas investigaciones para ampliar estos hallazgos, particularmente cuando se compara con otros posibles agentes farmacológicos.

          Translated abstract

          ABSTRACT Introduction: Venlafaxine was the first the first serotonin norepinephrine reuptake inhibitor antidepressant to authorized in Spain. Although there is no indication in the data sheet in the treatment of neuropathic pain, there are clinical practice guidelines in which venlafaxine appears in the first or second line of treatment. Development: Following a literature search, this article summarizes the most relevant pharmacological data of venlafaxine, as well as the specific literature of this drug in neuropathic pain. Conclusions: Venlafaxine is a safe and well tolerated drug for the symptomatic treatment of neuropathic pain. Although the current evidence is quite encouraging (at doses of at least 150 mg/day), further research is needed to extend these findings, particularly when is compared to other possible pharmacological agents.

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          Most cited references33

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          Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment.

          Neuropathic pain develops as a result of lesions or disease affecting the somatosensory nervous system either in the periphery or centrally. Examples of neuropathic pain include painful polyneuropathy, postherpetic neuralgia, trigeminal neuralgia, and post-stroke pain. Clinically, neuropathic pain is characterised by spontaneous ongoing or shooting pain and evoked amplified pain responses after noxious or non-noxious stimuli. Methods such as questionnaires for screening and assessment focus on the presence and quality of neuropathic pain. Basic research is enabling the identification of different pathophysiological mechanisms, and clinical assessment of symptoms and signs can help to determine which mechanisms are involved in specific neuropathic pain disorders. Management of neuropathic pain requires an interdisciplinary approach, centred around pharmacological treatment. A better understanding of neuropathic pain and, in particular, of the translation of pathophysiological mechanisms into sensory signs will lead to a more effective and specific mechanism-based treatment approach. Copyright 2010 Elsevier Ltd. All rights reserved.
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            Complex regional pain syndrome: practical diagnostic and treatment guidelines, 4th edition.

            This is the fourth edition of diagnostic and treatment guidelines for complex regional pain syndrome (CRPS; aka reflex sympathetic dystrophy).
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              The burden of neuropathic pain: a systematic review and meta-analysis of health utilities.

              Patients with neuropathic pain (NeuP) experience substantially lower health-related quality of life (HRQoL) than the general population. The aim of this systematic review and meta-analysis is to test the hypothesis that NeuP is associated with low levels of health utility. A structured search of electronic databases (MEDLINE, EMBASE, Cochrane Library and CINAHL) was undertaken. Reference lists of retrieved reports were also reviewed. Studies reporting utility single-index measures (preference based) in NeuP were included. Random effects meta-analysis was used to pool EQ-5D index utility estimates across NeuP conditions. The association of utilities and pre-defined factors (NeuP condition, patient age, sex, duration and severity of pain and method of utility scoring) was examined using meta-regression. Twenty-four studies reporting health utility values in patients with NeuP were included in the review. Weighted pooled utility score across the studies varied from a mean of 0.15 for failed back surgery syndrome to 0.61 for post-herpetic neuralgia and diabetic neuropathy. Although there was substantial heterogeneity (P<0.0001) across studies, we found little variation in utility as a function of patient and study characteristics. The single exception was a significant relationship (P<0.0001) between increasing neuropathic pain severity and a reduction in utility. This study confirms the hypothesis that patients with NeuP experience low utilities and therefore low HRQoL. However, the contribution of non-NeuP co-morbidity remains unclear. Neuropathic pain severity emerged as a primary predictor of the negative health impact of NeuP. Copyright 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                Role: ND
                Journal
                dolor
                Revista de la Sociedad Española del Dolor
                Rev. Soc. Esp. Dolor
                Inspira Network Group, S.L (Madrid, Madrid, Spain )
                1134-8046
                April 2018
                : 25
                : 2
                : 94-105
                Affiliations
                [1] Badajoz orgnameHospital Don Benito-Villanueva de la Serena orgdiv1Unidad del Dolor España
                Article
                S1134-80462018000200094
                10.20986/resed.2017.3592/2017
                91541299-3522-4d95-be9f-23fabe12eb4a

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 11 July 2017
                : 26 April 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 12
                Product

                SciELO Spain


                neuropathy,diabetic polyneuropathy,venlafaxine,Antidepresivos,dolor neuropático,Antidepressants,neuropathic pain,serotonin norepinephrine reuptake inhibitor,inhibidor recaptación serotonina noradrenalina,neuropatía,polineuropatía diabética,venlafaxina

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