세로토닌 재흡수 억제제, 세로토닌 노르에피네프린 재흡수 억제제, 노르아드레날린성 및 선택적 세로토닌성 항우울제가 통증에 미치는 효과 비교 (Comparison of Effect of SSRIs, SNRIs, and NaSSA on Pain)

서지정보

· 발행기관 : 대한정신약물학회
· 수록지 정보 : 대한정신약물학회지 / 23권 / 4호 / 176 ~ 182페이지
· 저자명 : 이현재, 민경준, 이영식, 나철, 한덕현

초록

본 연구에서는 우울증 환자들을 대상으로 SSRIs 투여군, SNRIs 투여군, NaSSA 투여군으로 나누어 통증에 미치는 효과를 비교하여 알아 보았다. 약물이 투여 된 4주간, SSRIs군, SNRIs군, NaSSA군에서 50% 통증이 관해 된 대상자 수가 각각 14명(28%), 20명(40%), 27명(54%)으로 사후검증에서 Na-SSA가 SSRIs에 비해 두 배 정도 통증에 대한 관해율이 높았다. 이처럼 본 연구 결과 우울증 환자들에서 NaSSA가 SS-RIs, SNRIs 보다 통증에 대한 관해 효과가 좋은 것으로 나타났다. 이전까지의 연구에서는 주로 SNRIs의 통증에 대한 효과가 많이 부각이 되었지만 본 연구를 통해 보았을 때 통증에서의 NaSSA의 효과에 대한 보다 더 다양하고 구체적인 연구와 검증이 필요할 것으로 판단된다.

영어초록

ObjectivezzSelective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and noradrenergic and specific serotonergic antidepressant (NaSSA) are extensively used to treat the patients with depression. Although depressed patients are complaining of somatic pain as a complication of depression, there has not been any straightforward comparative data of the effect of SSRIs, SNRIs, and NaSSA on pain. Therefore, in this study, we tried to figure out the effect of each drug i.e.SSRIs, SNRIs, and NaSSA, on pain by administrating each drug to three different groups of patient with depression.
MethodszzWe conducted a chart review of patients, who visited a university hospital. From January, 2010 to February,2012, total 150 inpatients who had been diagnosed as major depression by Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria, and administered any of three drugs [SSRIs (n=50), SNRIs (n=50), and NaSSA (n=50)] at least for fore weeks in the department of psychiatry in Chung-Ang University Hospital, were enrolled for this study. We compared and analyzed depressive symptoms and pain between three groups. Depressive symptoms and pain were evaluated by Korean version of the Hamilton Depression Rating Scale and visual analogue scale at baseline and fore weeks later.
ResultszzThere was no difference in the age, gender, severity of depression and pain among three groups. However, there was difference in 50% depressive symptomatic improvement rate in the following four weeks among three groups. The number of patient found to achieve 50% symptomatic improvement in SSRIs, SNRIs, and NaSSA group was 17 (34%), 20 (40%), and 34 (54%) in each group, respectively, indicating significantly higher improvement rate in NaSSA compared to SSRIs. During four weeks of administration period, significant difference in 50% pain improvement rate was observed among three groups.
The number of patient found to achieve 50% pain improvement in SSRIs, SNRIs, and NaSSA group was 14 (28%), 20 (40%),and 27 (54%) in each group, respectively, showing twice higher pain improvement rate in NaSSA compared to SSRIs.
ConclusionzzThis result indicates better efficacy of NaSSA on pain improvement compared to SSRIs, and SNRIs in depressed patients. Although the effect of pain improvement has been mainly focused on SNRIs, result from this study suggests the need for further research and validation on the effect of NaSSA for pain control.

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