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Global Translational Medicine New insights into chronic pain management

vortioxetine. Patients underwent VAS test for examination
of pain intensity on every visit. Emotional disturbances
rated by HADS and insomnia indicated using DSM-5
clinical criteria were tested only on the first visit.
Most patients with chronic pain had clinical depression
indicated by HADS and insomnia indicated by DSM-5
clinical criteria. About 74% of patients had sleep disorders
and 65% of patients had depression. Depression was
statistically rare in patients with neuropathic pain origin.
Incidence of emotional disorder was significantly lesser in
patients with neuropathic pain (33%) than in patients with
nociceptive origin (82%; P < 0.01). Insomnia was more
frequent in patients with nociceptive pain origin (82%)
compared with patients with neuropathic pain origin
(50%), but the present study was unable to demonstrate a
Figure 5. Classification of patients by demographic and clinical statistical difference (P = 0.129) (Figure 7).
characteristics, and examination methods. The presence of comorbid symptoms had no influence
HADS: Hospital anxiety and depression scale; VAS: Visual analog scale.
on pain relief after 12-week vortioxetine treatment.
Patients with clinical depression had 3.7-mm pain relief
The parameters that were assessed include pain intensity
relief, clinically apparent emotional disorders, and versus 3.25-mm pain relief in patients with no emotional
complains (P = 0.45). Patients with sleep disorders had 3.6-
presence of insomnia. Influence of pain duration, gender, mm pain reduction vs. 3.17-mm pain reduction in patients
age and presence of comorbid symptoms on pain reduction without insomnia (P = 0.37) (Figure 8).
were observed. Descriptive statistics were calculated for
all quantitative and qualitative variables. Student’s t-tests Patients with pain duration <12 months had 2.36-mm
st
were used for normally distributed variables. Categorical pain reduction after 1 week of vortioxetine treatment
variables were assessed using the Chi-square test. versus 2-mm pain reduction in patients with pain duration
Significance was based on two-tailed tests with a 5% level more than 12 months (P = 0.279). After 12 weeks, pain
of significance. All analyses were performed using SPSS reduction was 3.72 mm in the first group versus 3.3 mm
16.0 software. in patients with pain duration more than 12 months
(P = 0.45).
3. Results
The study demonstrated no statistical difference in
The age range of patients was 26 – 79 years. Twenty-three pain relief in patients with different pain origin. After
patients with chronic pain lasting more than 3 months 1 week of vortioxetine therapy, pain relief was 1 mm in
were classified: patients with neuropathic pain origin and 0.82 mm in
• Patients with nociceptive pain origin, including patients with nociceptive pain origin (P = 0.696). After
13 patients with low back pain (54%), four patients 12 weeks of treatment, pain relief was 3.33 mm in the first
with headache (16%), six patients with neuropathic group versus 3.59 mm in patients with nociceptive pain
mechanism-induced pain such as radiculopathy (P = 0.675).
(8%), two patients with spinal stenosis (8%), and two The present study demonstrated no influence of gender
patients with trigeminal neuralgia (8%); on pain reduction during all period of treatment (Table 1).
• Patients with pain duration <1 year and more than The group of patients aged <65 years had statistically
1 year; higher level of pain relief on 1 week (1.1 mm vs. 0.16 mm
st
• Patients aged <65 years and patients >65 years in old patients, P < 0.01) and 3 week of treatment
rd
(Figure 6). (2.35 mm vs. 1.7 mm, P = 0.05). All patients, regardless of
th
Pain relief was assessed after 1 week, 3 weeks, and age, had significant pain relief after the 12 week treatment
12 weeks of vortioxetine treatment in different groups (Figure 9).
categorized in accordance with pain origin, duration of
pain, gender, age, and presence of comorbid symptoms. 4. Discussion
The patients were followed up in the clinic after 1 week, The goal of our study was to explore pain relief in chronic
st
3 week, and 12 week of treatment with 10 mg pain patients of different neurological diseases with
th
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Volume 2 Issue 2 (2023) 5 https://doi.org/10.36922/gtm.312