伏硫西汀治疗神经病理性疼痛的相关研究进展

Research progress of vortioxetine in the treatment of neuropathic pain

神经病理性疼痛(Neuropathic pain,NP)作为一种常见、难治性的慢性疼痛,极易伴发情绪障碍而导致病情加重,严重影响患者的机体功能和生活质量。伏硫西汀是一种具有独特作用机制的新型多模态抗抑郁药,作为5-羟色胺(5-hydroxytryptamine,5-HT)能调节剂,通过5-HT转运体介导的5-HT再摄取,拮抗5-HT_(3)、5-HT_(1D)和5-HT_(7)血清素受体,激活5-HT_(1A)和5-HT_(1B)受体而发挥其药理活性。研究表明,伏硫西汀对疼痛、超敏反应和情绪障碍有效。在临床研究中,伏硫西汀10~20 mg/d的剂量在灼口综合征的短期和长期治疗中均有效。与其他抗抑郁药物相比,其临床反应和缓解率更高,可接受性、安全性和耐受性更好,作用潜伏期更低。本文对伏硫西汀治疗NP的可能机制、临床效果及安全性等进行综述,以期为伏硫西汀在NP中的应用提供参考。

Neuropathic pain(NP),as a common and refractory chronic pain,is easily accompanied by mood disorders,which leads to the aggravation of the condition and seriously affects the patient′s body function and quality of life.Vortioxetine is a novel multimodal antidepressant with a unique mechanism of action.As a 5-hydroxytryptamine(5-HT)serotonergic modulator,vortioxetine exerts its pharmacological activity by antagonizing 5-HT_(3),5-HT_(1D) and 5-HT_(7) serotonin receptors and activating 5-HT_(1A) and 5-HT_(1B) receptors through 5-HT transporter-mediated 5-HT reuptake.Experimental and clinical studies have shown that it has curative effect on pain,allergic reactions,and mood disorders.In clinical study,the dose of vortioxetine 10~20 mg/d is effective in the short-term and long-term treatment for patients with burning mouth syndrome(BMS).Compared with other antidepressants,it has higher clinical response and remission rates,better acceptability,safety and tolerability,and lower latency of action.This article reviews the possible mechanism,clinical efficacy and safety of vortioxetine in the treatment of NP,in order to provide reference for the application of vortioxetine in NP.