ABSTRACT
Forty patients with pain syndromes of both organic and psychogenic origin of at least 6 months' duration were included in a double-blind controlled study of a new rather selective serotonin uptake inhibitor, Zimelidine, versus placebo. Patients in the Zimelidine group experienced significantly more pain relief and tended to be able to reduce their need for analgesics more often than the patients in the placebo group. In the Zimelidine group 4 patients were excluded due to nausea and intestinal troubles versus only 1 patient in the placebo group. However, among the patients who completed the trial the side-effects were mild.
Subject(s)
Pain/drug therapy , Pyridines/therapeutic use , Serotonin Antagonists/therapeutic use , Adult , Aged , Allylamine/adverse effects , Allylamine/analogs & derivatives , Allylamine/therapeutic use , Clinical Trials as Topic , Double-Blind Method , Female , Humans , Male , Middle Aged , Pain/physiopathology , Pyridines/adverse effects , Serotonin/physiology , Serotonin Antagonists/adverse effectsABSTRACT
In 45 consecutive patients with chronic pain syndromes endorphins, fraction I of the cerebrospinal fluid and pain measures by means of electric stimulation via saline electrodes were investigated. In patients with high levels of fraction I (above median) pain threshold, PT and tolerance level, TL, in condition C (continuous stimulation increase) were found to be significantly higher than in patients with low levels of fraction I (below median). The results indicate that the endorphins are one of the physiological factors that contribute to the pain threshold and the tolerance level.
Subject(s)
Endorphins/cerebrospinal fluid , Pain/cerebrospinal fluid , Adult , Chronic Disease , Electric Stimulation , Female , Humans , Male , Middle Aged , Psychophysiologic Disorders/cerebrospinal fluid , Sensory Thresholds , Sex FactorsABSTRACT
A series of 37 patients with chronic pain was investigated with regard to neurologic and psychiatric variables. Twenty of the patients were classified as having mainly organic (= somatogenic) pain syndromes while 17 patients were rather suffering from psychogenic pain syndromes. Samples of lumbar cerebrospinal fluid (CSF) were obtained from the patients and analyzed for the presence of opiate receptor-active material, here called endorphins. Patients classified as having mainly organic pain syndromes were found to have significantly lower endorphin levels than patients with predominantly psychogenic pain syndromes. In the total group of patients as well as in the two subgroups, there was a significant correlation between CSF endorphin levels and the depth of depressive symptomatology as reported by the patients. On the other hand, there was no correlation between CSF endorphin levels and extent of anxiety or motor retardation. It is concluded that CSF endorphins reflect central processes involved in chronic pain syndromes.
