Several psychopharmacologic agents are employed as adjunct or primary agents for managing pain.
The previously-described surroundings of
ineffective and even dangerous opioid therapies, it is warranted to examine the
role of atypical antipsychotics (AAs) in pain management. Therefore, a
systematic review conducted by Jimenez XF et al elaborated the efficacy
safety, mechanism of action and risk/ benefit of using AAS in chronic pain
management.
Several psychopharmacologic agents are employed as
adjunct or primary agents for managing pain. Atypical antipsychotics (AAs) have
also been used as adjuncts for managing pain in various ways; although, their
efficiency in this capacity is not clear.
All studies exploring AA use were reviewed under a
systematic review. Evaluation of three literature databases was done using the
word combinations of "pain" and diversity of commonly-prescribed AAs
(Iloperidone, Ziprasidone, Olanzapine, Lurasidone, Risperidone, Paliperidone,
Quetiapine, Aripiprazole, Clozapine) and picked randomised control trials, case
series/reports, and retrospective analyses. A PRISMA diagram was used to
represent the study selection method.
Aripiprazole, Risperidone, Ziprasidone, Olanzapine, and
Quetiapine are the only AAs with published investigations in pain syndromes.
Out of these, Quetiapine and Olanzapine presented the most combined studies.
Olanzapine presents preliminary and uniform effectiveness in headache/migraine
and fibromyalgia; however, only one investigation was a randomised controlled
trial with Level I evidence of effectiveness. Other AAs (Quetiapine involved)
fail to illustrate the efficiency in pain syndromes and/or lack strong study
patterns.
Few investigations have been directed to assess the
analgesic outcomes of AAs. The collective verdicts of multiple studies
assessing Olanzapine in pain syndromes recommend a high yet preliminary level
of evidence of effectiveness, warranting prospective studies in numerous pain
syndrome settings. Pharmacological mechanisms of AA action are developed, and
the verdicts of this review are explored. Benefits and risks of using AAs in
chronic pain are refined, and investigational suggestions and future objectives
are investigated.
Clin J Pain. 2017 Oct 26
A Systematic Review of Atypical Antipsychotics in Chronic Pain Management: Olanzapine Demonstrates Potential in Central Sensitization, Fibromyalgia, and Headache/Migraine.
Jimenez XF et al.
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