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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of long experience with psychotropic drugs in the treatment of chronic and severe pain resistant to ordinary therapy are reported. In 103 in-patients with chronic and severe pain caused by neurological conditions and treated with a combination of thymoleptics and neuroleptics, 82% showed a marked improvement. These encouraging results are compared with the results of other studies published in this field. The pharmacological basis of this good action is briefly discussed, together with the advantages of the use of psychotropic drugs and especially the combination of thymoleptics and neuroleptics. A clearcut dosage schedule for in- and out-patients using imipramine (Tofranil) or chlorimipramine (Anafranil) and haloperidol (Haldol) is established.
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PMID:[The treatment of chronic pain with psychotropic drugs]. 20 60

Forty-six patients were admitted to an open general practice study of clomipramine (Anafranil) in the treatment of long-standing rheumatic pain; forty-one patients completed the trial. The duration of the trial was 56 days during which patients received daily doses of either 10 mg or 25 mg of clomipramine. Assessments were made at fortnightly intervals. Patients were assessed for pain using a visual analogue scale, analgesic requirement, joint pain, other pain and morning stiffness. At the completion of the study patients were asked whether the addition of clomipramine to their treatment was better, the same or worse than no additional treatment. Twenty-one patients (57%) felt that it was better, four felt that it was the same and twelve said that it was worse. The doctor also similarly recorded his preference at the end of the trial. In twenty-two cases (60%) the doctor felt it was better, in eight that there was no difference and in seven that it was worse. There was no difference between the 10 mg and the 25 mg regime. It is suggested that better control of rheumatic symptoms can be achieved in some patients by the addition of small daily doses of clomipramine to their standard anti-rheumatic therapy. The author expresses the view that further research in this field is merited.
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PMID:Clomipramine (Anafranil) and musculo-skeletal pain in general practice: a pilot, open, non-comparative study of long-standing rheumatic pain. 30 Nov 5

There have been reports that tricyclic antidepressants, such as clomipramine (Anafranil), alleviate some forms of chronic pain in man. This paper examines and compares the pharmacological properties of centrally-acting analgesics and the tricyclic antidepressants, to establish a scientific basis for the observed clinical effects of the tricyclics. Opiates and tricyclic antidepressants share a number of pharmacological properties including activity in animal tests for antidepressant and analgesic activity. In doses which alone were not analgesic, clomipramine potentiated whilst maprotiline (Ludiomil) attenuated the analgesic activity of single doses of morphine in laboratory animals. However, when morphine and tricyclic agent were given repeatedly over several days, clomipramine enhanced or accelerated the onset of morphine tolerance, whereas maprotiline delayed tolerance. It is concluded that there is much experimental data to support the belief that tricyclics such as clomipramine may be useful in chronic clinical pain. Where an opiate is being administered chronically (for example in terminal pain) the concomitant administration of maprotiline may delay onset of tolerance.
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PMID:Antidepressants and pain: a review of the pharmacological data supporting the use of certain tricyclics in chronic pain. 86 85

82 patients with chronic pain resulting from mononeuropathy were treated with psychotropic drugs in an open therapeutic study. In this study we found that treatment with a combination of clomipramine (Anafranil) and small doses of neuroleptics was significantly superior to therapy with neuroleptics alone. In a subsequent double-blind study, it was attempted for the first time to determine the efficacy of clomipramine compared to that of acetylsalicylic acid in 48 patients with painful mono- and polyneuropathies. The test was carried out in a cross-over trial with two sequence groups. We evaluated assessments of pain by both patients and doctors, and were able to prove statistically that clomipramine possesses a significantly greater efficacy compared to that of acetylsalicylic acid. By taking into account recent anatomical, biochemical and pharmacological studies, it can be concluded that clomipramine probably has-in addition to the action on peripheral receptors-a direct effect upon pain modulation systems. It seems possible that clomipramine activates serotonin-containing neurons of the endorphin-mediated analgesia system that control pain transmission in the CNS.
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PMID:An open and double-blind cross-over study on the efficacy of clomipramine (Anafranil) in patients with painful mono- and polyneuropathies. 612 61