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The Coexistence of Neuropathic Pain, Sleep, and Psychiatric Disorders: A Novel Treatment Approach

  [ 175 votes ]   [ 1 Comment ]
By Charles E Argoff • • January 24, 2007

Journal: Clinical Journal of Pain. 23(1):15-22, January 2007.

Author: Argoff, Charles E. MD

The diagnosis and treatment of neuropathic pain may be complicated by comorbid conditions such as sleep disturbances, depression, and anxiety. The interrelationship between the index neuropathic pain state and these comorbidities is complex: comorbid conditions exacerbate pain, and in turn, pain exacerbates the comorbid conditions.

Because comorbidities can negatively impact response to pain treatment, healthcare providers should assess comorbidities as part of the diagnostic work-up, and management strategies should be designed to treat the whole patient, not just the pain.

Theoretically, therapies that not only reduce pain, but also improve sleep and reduce anxiety and depression can provide multiple benefits without the risk of increased side effects inherent in combination therapy.

Anticonvulsants and antidepressants have demonstrated efficacy in improving neuropathic pain and positively impacting comorbid sleep and mood disturbances. Novel anticonvulsants that can address one or more comorbidities in addition to pain may represent viable treatment options for patients with neuropathic pain.

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Article Comments Post a Comment

"novel treatment approach"
Posted by: ninaytj
Jan 27, 2007
There is nothing novel about this treatment approach. They put me on this stuff back in 93-95. All it did was make me dizzy, light-headed and unable to keep my mind clear and focused. It made it extremely hard to work. After a month I abandoned the meds and the doc. This approach was used because the doctor was afraid to prescribe opiods for the pain. When I looked up the side effects it said: "Feeling sleepy, lightheaded, or unable to think clearly. Avoid driving, doing other tasks or activities that require you to be alert until you see how this medicine affects you. Dry mouth. Frequent mouth care, sucking hard candy, or chewing gum may help. " I will take the opiods any day. I never feel sleepy or unable to think clearly. Best of all it keeps my pain at a 3 on most days. Some days nothing works.
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