The neurobiology of depression and the dilemma of pain treatment

Author Info

Stefan Gebhardt

Corresponding Author

Stefan Gebhardt
Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Germany

A B S T R A C T

Pain is a known side symptom of a depressive disorder. A recent meta-analysis suggests strongly that treatment of comorbid pain in primary depressive disorders is a treatment of the depressive disorder itself. This seems to be mostly independent of the treatment method. However, it is essential that the depressive disorder is treated successfully. For the individual patient, this means that the choice of antidepressant is based on the individual effect/side effect profile, not on a supposedly better analgesic effect of antidepressants. As well, psychotherapeutic strategies and complementary therapies, such as music therapy, are highly recommended depending on the individual case. The improvement of the affective system leads to the normalization of the pain system resulting in a relief of pain. Of course, this does not preclude additional suitable analgesic therapy, which in turn may have effects on depression. Although this approach seems to be strongly evident, it is hardly implemented in practice. A number of obstacles seem to interfere with the establishment of appropriate general and individual therapeutic strategies and lead to a dilemma in pain management of depressive patients: research and publication bias, obstacles in areas of expertise and professionals’ interests as well as in psychopathology itself are discussed in this paper.

Article Info

Article Type

Research Article

Publication history

Received: Mon 09, Jul 2018
Accepted: Mon 03, Sep 2018
Published: Sat 13, Oct 2018

Copyright

© 2023 Stefan Gebhardt. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.NNB.2018.10.007