Abstract

RODRIGO, M. D. et al. Effectiveness and tolerability as coadjuvant antidepressant treatment in patients with chronic pain. Rev. Soc. Esp. Dolor [online]. 2004, vol.11, n.2, pp.49-55. ISSN 1134-8046.

Introduction: The aim of this study was to determine the effectiveness of sertraline as antidepressant and its tolerability through the control of side effects attributable to potential drug interactions, when used in combination with other analgesic and coadjuvant drugs in patients with chronic pain syndromes of different etiologies. Method: We studied 34 patients (28 women and 6 men) with an average age of 59.3 ± 15.9 years (range 22-78). Their referral had an inpatient origin in 3 cases and an outpatient origin in 31. Pain etiology was osteoarticular in 15 cases, neuropathic in 11, mixed in 6 and vascular in 2. Its cause was degenerative in 15 patients, traumatic in 7, carcinogenic in 3, essential in 2, ischemic in 1 and some other cause in 6. The severity of associated depression was assessed before and after the treatment with sertraline, using the Hamilton test. Dosage used. Length of treatment. Associated drugs. Side effects. Follow-up. Results: Depression severity scores obtained before the treatment suggested severe depression in 13 patients and moderate depression in 21. After the treatment, depression scores were obtained in 27 patients, with normal values in 23 patients and abnormal in 4. Initial and final average daily dose of sertraline was 26.4 ± 5.9 y 50.7 ± 4.2 mg, respectively, and the average length of treatment was 10.5 ± 4.7 months. Adjuvant therapy with NSAI was used in 82.3% of the patients, weak opiate in 64.7%, powerful opiate in 26.4%, anticonvulsant in 61.7%, corticoid in 2.9% and hypnotic in 5.8%. No side effects associated to the administration of sertraline were found in any patient. Mood improvement was described as moderate in 4 patients, satisfactory in 18 and very satisfactory in 5. Eighteen patients still continue with the treatment, 6 have been discharged, 6 have been lost, 1 has died and 3 have discontinued the treatment because of lack of effectiveness in 1 case and patient election in 2. Conclusions: Sertraline has shown an excellent tolerability in these patients when used in combination with other analgesic and coadjuvant drugs. This drug has a particularly high therapeutic value in cases of secondary depression associated to several pain syndromes.

Keywords : Chronic pain; Antidepressant drugs; Sertraline.

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