抑郁症及抗抑郁药物对疼痛阈值的影响

Effect of depression and antidepressants on pain threshold

抑郁症是一种复杂的临床疾病,患者除了自身情绪的改变外,对于疼痛的感知也会发生变化。临床中,抑郁症患者的疼痛阈值增高常有报道,抗抑郁药物在治疗抑郁症的同时,也会影响疼痛阈值。由于病理生理的复杂性,目前关于抑郁症及抗抑郁药物对疼痛阈值的影响及机制的结论阐述较为单一,但疼痛阈值背后的大脑皮层、脑干的神经机制研究的创新层出不穷。本文就抑郁症及抗抑郁药物对疼痛阈值的不同影响及潜在的作用机制进行综述,从大脑、脑干、脊髓中的受体与递质方面探讨疼痛传递及调节的潜在神经机制,旨在为抑郁症患者疼痛阈值改变的机制研究及临床治疗提供思路。

Depression is a complex clinical disease,in addition to their own emotional changes,the perception of pain will also change significantly.Clinically,it is often reported that the pain threshold of depressed patients is increased,and antidepressants will also affect the pain threshold on the basis of the original treatment of depression.Due to the complexity of pathophysiology,the current conclusions on the influence and mechanism of depression and antidepressants on pain threshold are still relatively superficial,but the neural mechanism of the cerebral cortex and brainstem behind the pain threshold has been innovated in recent years.This article reviews the different effects and potential mechanisms of depression and antidepressant drugs on pain threshold,and discusses the potential neural mechanisms of pain transmission and regulation from the aspects of receptors and transmitters in the brain,brainstem and spinal cord,aiming to provide new ideas for the study and clinical treatment of the mechanism of pain threshold change in patients with depression.