Zusammenfassung
Schmerz ist bei vielen somatischen Erkrankungen ein häufiges Symptom. Chronische Schmerzen
können Auslöser für affektive Störungen und Angststörungen sein; sie können aber auch
als Symptome psychischer Erkrankungen - wie etwa einer Depression - auftreten, so
dass ihnen keine somatische Ursache zugrunde liegt. Deswegen ist die Diagnostik der
den Schmerzen zugrunde liegenden Ursachen in der Praxis oft sehr schwierig. Die Neurotransmitter
Serotonin und Noradrenalin spielen nicht nur in der Pathophysiologie der Depression
eine wichtige Rolle, sondern sind auch wichtige Mediatoren in der Schmerzregulierung.
Bei der Behandlung chronischer Schmerzen und Depressionen werden daher schon lange
erfolgreich Antidepressiva zur Symptombekämpfung eingesetzt. Der neue Wirkstoff Duloxetin
ist ein Serotonin- und Noradrenalin-Wiederaufnahmehemmer. Er wirkt antidepressiv und
schmerzlindernd und ist zugelassen zur Behandlung von Schmerzen bei Diabetischer Polyneuropathie.
Summary
Pain is a common symptom in many somatic illnesses. Chronic pain can trigger affective
disorders and anxiety states. But they can also be symptoms of mental disease, e.g.
depression, without somatic cause. For this reason diagnosis of the underlying cause
of pain can be very difficult in daily practice. Two neurotransmitters, serotonin
and noradrenaline, play an important role not only in the pathophysiology of depression
but importantly also as mediators in pain regulation. Thus antidepressants have for
a long time been used in the treatment of chronic pain and depression. The newly available
duloxetine is a drug with properties of both serotonin and noradrenaline re-uptake
inhibition. This drug acts not only as an antidepressant but also reduces pain. It
has been approved for the treatment of pain in diabetic neuropathy.
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Prof. Dr. Göran Hajak
Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie der Universität
Regensburg
Universitätsstraße 84
93053 Regensburg
Phone: 0941/9412011
Fax: 0941/9412015
Email: goeran.hajak@medbo.de