Psychotropic adjuvant analgesics for pain in cancer and AIDS Journal Article


Author: Breitbart, W.
Article Title: Psychotropic adjuvant analgesics for pain in cancer and AIDS
Abstract: The 'WHO Analgesic Ladder' is a well validated approach for the selection of appropriate analgesic therapy for cancer pain as well as pain in AIDS. The mainstay of analgesic intervention for cancer and AIDS pain of moderate to severe intensity continues to be the appropriate use of opioid analgesics. There is, however, a growing appreciation for the role of adjuvant analgesics, such as antidepressants and other psychotropic medications, at each step of the WHO Analgesic Ladder, particularly in the treatment of neuropathic pain. Knowledge of the indications and usefulness of psychotropic analgesic drugs in cancer and AIDS pain populations will be most important to clinicians practicing in psycho-oncology/AIDS settings, particularly since these drugs are useful not only in the treatment of psychiatric complications of cancer and AIDS, but also as adjuvant analgesic agents in the management of pain. This paper reviews the literature on the use of antidepressants, psychostimulants, neuroleptics, anticonvulsants and other psychotropic analgesics in the management of cancer and AIDS pain. Mechanisms of analgesia, drug selection, and recommendations for clinical usage are discussed. The appropriate and timely use of psychotropic adjuvant analgesic drugs represents an opportunity for active psychiatric contribution to the multidisciplinary management of cancer and AIDS pain.
Keywords: review; treatment planning; adjuvant therapy; neoplasms; pain; haloperidol; methylphenidate; dexamethasone; cancer pain; drug therapy, combination; psychotropic drugs; acquired immunodeficiency syndrome; chronic pain; analgesics; alprazolam; venlafaxine; analgesia; pain assessment; clonazepam; fluoxetine; fluphenazine; paroxetine; sertraline; valproic acid; mexiletine; pimozide; gabapentin; dexamphetamine; pemoline; amitriptyline; trazodone; clomipramine; desipramine; nortriptyline; hydroxyzine; aids related complex; nefazodone; doxepin; imipramine; adjuvants, pharmaceutic; humans; human; maprotiline; methopromazine
Journal Title: Psycho-Oncology
Volume: 7
Issue: 4
ISSN: 1057-9249
Publisher: John Wiley & Sons  
Date Published: 1998-07-01
Start Page: 333
End Page: 345
Language: English
DOI: 10.1002/(sici)1099-1611(199807/08)7:4<333::aid-pon365>3.0.co;2-f
PUBMED: 9741072
PROVIDER: scopus
DOI/URL:
Notes: Review -- Export Date: 12 December 2016 -- Source: Scopus
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MSK Authors
  1. William S Breitbart
    350 Breitbart