Peculiarities of pharmacological correction of somatic manifestations of depression and cognitive decline in patients with anxiety-depressive disorders during wartime

November 1, 2022
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The high prevalence of depression in the world and in Ukraine in particular and also the growing prevalence of anxiety-depressive disorders in our country during the war makes relevant the question of pharmacological correction of neuropathic pain and depression-associated cognitive decline. The purpose of this review is to analyze current literature data on the mechanism of action of duloxetine and the results of systematic reviews, meta-analyses, randomized clinical trials on the its ability to improve the somatic manifestations of anxiety-depressive disorders, neuropathic pain and cognitive functions. The combination of anti-anxiety, antidepressant, analgesic effect and own procognitive activity together with the combined mechanism of action, good safety profile, satis­factory tolerability makes duloxetine a promising drug for correcting somatic manifestations of anxiety-depressive disorders, neuropathic pain, chronic postoperative pain, fibromyalgia, diabetic peripheral neuropathic pain, osteoarthritis of knee joints. Among the large number of antidepressants, duloxetine has a direct analgesic and its own procognitive effect, which makes it possible to include it in a multimodal postoperative analgesic protocol for the management of patients with combat surgical trauma. The cost-effectiveness of duloxetine emphasizes the feasibility of its use even without additional screening for depression.

References

  • 1. WHO (2021) Depression. Key facts. http://www.who.int/news-room/fact-sheets/detail/depression.
  • 2. IHME (2019) vizhub.healthdata.org/gbd-results.
  • 3. Lim I.C.Z.Y., Tam W.W.S., Chudzicka-Czupała A. et al. (2022) Prevalence of depression, anxiety and post-traumatic stress in war- and conflict-afflicted areas: a meta-analysis. Front Psychiatry, 13: 978703. doi: 10.3389/fpsyt.2022.978703.
  • 4. Howlett J.R., Nelson L.D., Stein M.B. (2022) Mental Health Consequences of Traumatic Brain Injury. Biol. Psychiatr., 91(5): 413–420. doi: 10.1016/j.biopsych.2021.09.024.
  • 5. Janssen P.G.J., van Est L.A.C., Hilbink M. et al. (2022) Social cognitive performance in posttraumatic stress disorder: a meta-analysis. J. Affect. Disord., 297: 35–44. doi: 10.1016/j.jad.2021.09.082.
  • 6. Luo W., Luo L., Wang Q. et al. (2022) Disorder-specific impaired neurocognitive function in major depression and generalized anxiety disorder. J. Affect. Disord., 318: 123–129. doi: 10.1016/j.jad.2022.08.129.
  • 7. Nyberg J., Henriksson M., Wall A. et al. (2021) Anxiety severity and cognitive function in primary care patients with anxiety disorder: a cross-sectional study. BMC Psychiatr., 21(1): 617. doi: 10.1186/s12888-021-03618-z.
  • 8. Kriesche D., Woll C.F.J., Tschentscher N. et al. (2022) Neurocognitive deficits in depression: a systematic review of cognitive impairment in the acute and remitted state. Eur. Arch. Psychiatry Clin. Neurosci., doi: 10.1007/s00406-022-01479-5.
  • 9. Couette M., Mouchabac S., Adrien V. et al. (2022) Functional neuro-anatomy of social cognition in posttraumatic stress disorder: A systematic review. Psychiatry Res., 315: 114729. doi: 10.1016/j.psychres.2022.114729.
  • 10. Gupta S., Guleria R.S. (2022) Involvement of Nuclear Factor-κB in Inflammation and Neuronal Plasticity Associated with Post-Traumatic Stress Disorder. Cells, 11(13): 2034. doi: 10.3390/cells11132034.
  • 11. Chen K.Y., Li R.Y. (2022) Efficacy and safety of different antidepressants and anticonvulsants in central poststroke pain: a network meta-analysis and systematic review. PLoS One, 17(10): e0276012. doi: 10.1371/journal.pone.0276012.
  • 12. Rong W., Zhang C., Zheng F. et al. (2021) Persistent moderate to severe pain and long-term cognitive decline. Eur. J. Pain, 25(9): 2065–2074. doi: 10.1002/ejp.1826.
  • 13. Moisset X., Bouhassira D., Avez Couturier J. et al. (2020) Pharmacological and non-pharmacological treatments for neuropathic pain: Systematic review and French recommendations. Rev. Neurol. (Paris), 176(5): 325–352. doi: 10.1016/j.neurol.2020.01.361.
  • 14. Park J.J., Kwon A., Noh T.I. et al. (2022) Efficacy of pelvic floor muscle exercise or therapy with or without duloxetine: a systematic review and network Meta-analysis. Aging Male, 25(1): 145–155. doi: 10.1080/13685538.2022.2069238.
  • 15. Muscatello M.R.A., Zoccali R.A., Pandolfo G. et al. (2019) Duloxetine in Psychiatric Disorders: Expansions Beyond Major Depression and Generalized Anxiety Disorder. Front Psychiatr., 10: 772. doi: 10.3389/fpsyt.2019.00772.
  • 16. Pan Z., Grovu R.C., Cha D.S. et al. (2017) Pharmacological Treatment of Cognitive Symptoms in Major Depressive Disorder. CNS Neurol. Disord. Drug Targets., 16(8): 891–899. doi: 10.2174/1871527316666170919115100.
  • 17. mozdocs.kiev.ua/likiview.php?id=45706.
  • 18. Уніфікований клінічний протокол первинної, вторинної (спеціалізованої) та третинної (високоспеціалізованої) медичної допомоги. Депресія. zakononline.com.ua/documents/show/595___595.
  • 19. Koh I.J., Kim M.S., Sohn S. et al. (2019) Duloxetine Reduces Pain and Improves Quality of Recovery Following Total Knee Arthroplasty in Centrally Sensitized Patients: A Prospective, Randomized Controlled Study. J. Bone Joint Surg. Am., 101(1): 64–73. doi: 10.2106/JBJS.18.00347.
  • 20. Otsuki S., Okamoto Y., Ikeda K. et al. (2022) Perioperative duloxetine stration reduces pain after high tibial osteotomy and non-steroidal anti-inflammatory administration: a prospective, controlled study. Knee, 38: 42–49. doi: 10.1016/j.knee.2022.07.006.
  • 21. Tsuji O., Kosugi S., Suzuki S. et al. (2021) Effectiveness of Duloxetine for Postsurgical Chronic Neuropathic Disorders after Spine and Spinal Cord Surgery. Asian Spine J.,15(5): 650–658. doi: 10.31616/asj.2020.0191.
  • 22. Rodrigues-Amorim D., Olivares J.M., Spuch C. et al. (2020) Systematic Review of Efficacy, Safety, and Tolerability of Duloxetine. Front. Psychiatr., 11: 554899. doi: 10.3389/fpsyt.2020.554899.
  • 23. Szekeres G., Rozsa S., Dome P. et al. (2021) A Real-World, Prospective, Multicenter, Single-Arm Observational Study of Duloxetine in Patients With Major Depressive Disorder or Generalized Anxiety Disorder. Front. Psychiatr., 12: 689143. doi: 10.3389/fpsyt.2021.689143.
  • 24. Enomoto H., Fujikoshi S., Funai J. et al. (2017) Assessment of direct analgesic effect of duloxetine for chronic low back pain: post hoc path analysis of double-blind, placebo-controlled studies. J. Pain Res., 10: 1357–1368. doi: 10.2147/JPR.S133396.
  • 25. Hirase T., Hirase J., Ling J. et al. (2021) Duloxetine for the Treatment of Chronic Low Back Pain: A Systematic Review of Randomized Placebo-Controlled Trials. Cureus, 13(5): e15169. doi: 10.7759/cureus.15169.
  • 26. Jia Z., Yu J., Zhao C. et al. (2022) Outcomes and Predictors of Response of Duloxetine for the Treatment of Persistent Idiopathic Dentoalveolar Pain: A Retrospective Multicenter Observational Study. J. Pain Res., 15: 3031–3041. doi: 10.2147/JPR.S379430.
  • 27. Rosenblat J.D., Kakar R., McIntyre R.S. (2015) The Cognitive Effects of Antidepressants in Major Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Int. J. Neuropsychopharmacol., 19(2): pyv082. doi: 10.1093/ijnp/pyv082.
  • 28. Mehta P., Basu A., Ahmed S. (2022) Effectiveness and adverse effects of the use of mirtazapine as compared to duloxetine for fibromyalgia: real-life data from a retrospective cohort. Rheumatol. Int., 42(9): 1549–1554. doi: 10.1007/s00296-022-05135-y.
  • 29. Bidari A., Moazen-Zadeh E., Ghavidel-Parsa B. et al. (2019) Comparing duloxetine and pregabalin for treatment of pain and depression in women with fibromyalgia: an open-label randomized clinical trial. Daru, 27(1): 149–158. doi: 10.1007/s40199-019-00257-4.
  • 30. Zhou Q., Chen J., Yu W. et al. (2022) The Effectiveness of Duloxetine for Knee Osteoarthritis: An Overview of Systematic Reviews. Front. Physiol., 13: 906597. doi: 10.3389/fphys.2022.906597.
  • 31. Osani M.C., Bannuru R.R. (2019) Efficacy and safety of duloxetine in osteoarthritis: a systematic review and meta-analysis. Korean J. Intern. Med., 34(5): 966–973. doi: 10.3904/kjim.2018.460.
  • 32. Lenhard N.K., Sullivan J.K., Ross E.L. et al. (2022) Does Screening for Depressive Symptoms Help Optimize Duloxetine Use in Knee Osteoarthritis Patients With Moderate Pain? A Cost-Effectiveness Analysis. Arthritis Care Res (Hoboken), 74(5): 776–789. doi: 10.1002/acr.24519.
  • 33. Petersen K.K., Drewes A.M., Olesen A.E. et al. (2022) The effect of duloxetine on mechanistic pain profiles, cognitive factors and clinical pain in patients with painful knee osteoarthritis-A randomized, double-blind, placebo-controlled, crossover study. Eur. J. Pain, 26(8): 1650–1664. doi: 10.1002/ejp.1988.
  • 34. Qureshi Z., Ali M.N., Khalid M. (2022) An Insight into Potential Pharmacotherapeutic Agents for Painful Diabetic Neuropathy. J. Diabetes Res., 2022: 9989272. doi: 10.1155/2022/9989272.
  • 35. Pop-Busui R., Boulton A.J.M., Feldman E.L. et al. (2017) Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care, 40(1): 136–154. doi.org/10.2337/dc16-2042.
  • 36. D’Souza R.S., Barman R., Joseph A., Abd-Elsayed A. (2022) Evidence-Based Treatment of Painful Diabetic Neuropathy: a Systematic Review. Curr Pain Headache Rep., 26(8): 583–594. doi: 10.1007/s11916-022-01061-7.
  • 37. Shah I., Ahmad W., Islam M. et al. (2022) A Prospective Observational Study Comparing the Efficacy and Safety of Duloxetine and Pregabalin in Diabetic Peripheral Neuropathic Pain. Cureus, 14(9): e28683. doi: 10.7759/cureus.28683.