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"Pain ladder", or analgesic ladder, was created by the World Health Organization (WHO) as a guideline for the use of drugs in the management of pain. Originally published in 1986 for the management of cancer pain , it is now widely used by medical professionals for the management of all types of pain .
The drug is also under investigation as an antidepressant and for the treatment of neuropathic pain. It is related in chemical structure to venlafaxine. Due to being an opioid, there is risk of abuse and addiction, but it does have less abuse potential, respiratory depression, and constipation compared to other opioids (hydrocodone, oxycodone ...
In addition to post-treatment relapse, depressive symptoms can even recur in the course of long-term therapy (tachyphylaxis). Also, currently available antidepressants all elicit undesirable side-effects, and new agents should be divested of the distressing side-effects of both first and second-generation antidepressants. [6]
An analgesic adjuvant is a medication that is typically used for indications other than pain control but provides control of pain in some painful diseases. This is often part of multimodal analgesia, where one of the intentions is to minimize the need for opioids. [1] [2] [3]
The risk factors [110] for treatment resistant depression are: the duration of the episode of depression, severity of the episode, if bipolar, lack of improvement in symptoms within the first couple of treatment weeks, anxious or avoidant and borderline comorbidity and old age. Treatment resistant depression is best handled with a combination ...
What’s more, once a person has tried two different antidepressants, stayed with each one for long enough to feel the effects, and doesn’t get relief, their depression is considered treatment ...
A 2012 meta-analysis concluded that antidepressant treatment favorably affects pain, health-related quality of life, depression, and sleep in fibromyalgia syndrome. Tricyclics appear to be the most effective class, with moderate effects on pain and sleep, and small effects on fatigue and health-related quality of life. The fraction of people ...
The Texas Medication Algorithm Project (TMAP) [1] is a decision-tree medical algorithm, the design of which was based on the expert opinions of mental health specialists.It has provided and rolled out a set of psychiatric management guidelines for doctors treating certain mental disorders within Texas' publicly funded mental health care system, along with manuals relating to each of them The ...