Article August 1, 2004

Common Pathways of Depression and Pain

Pedro L. Delgado, MD

J Clin Psychiatry 2004;65(suppl 12):16-19

Article Abstract

Depressive disorders are chronic conditions that produce both emotional and physical symptoms.Increasing evidence suggests that in some patients with depressive disorders a neurodegenerative processmay occur, highlighting the importance of early and aggressive intervention. Serotonin (5-HT)and norepinephrine (NE) neurotransmitter systems influence neuroplasticity in the brain, and both areinvolved in mediating the therapeutic effects of most currently available antidepressants. Some dual-actionantidepressants have been shown to be effective in managing the pain symptoms associatedwith depression. These agents may have advantages over others by treating a wider array of physicalsymptoms. Additionally, these agents may also have a role in modulating neurogenesis and otherneuroplastic changes, thereby leading to more complete recovery in patients suffering from the emotionaland physical symptoms of chronic depression.