REVISTA

Olanzapina combinado con opioides en el dolor neuropático

Valoración Valoración: 4 Estrellas

Descripción: El tratamiento del dolor neuropático con opioides y olanzapina podría mejorar el sueño y disminuir efectos secundarios, como el vómito.

TITULO FUENTE ORIGINAL:

Usefulness of olanzapine as an adjunct to opioid treatment and for the treatment of neuropathic pain.

AUTORES:

Torigoe K, Nakahara K, Rahmadi M, Yoshizawa K, Horiuchi H, Hirayama S, Imai S, Kuzumaki N, Itoh T, Yamashita A, Shakunaga K, Yamasaki M, Nagase H, Matoba M, Suzuki T, Narita M.

REVISTA ABREV.:

Anesthesiology

AÑO:

2012

REFERENCIA:

116(1):159-69

DOI:

10.1097/ALN.0b013e31823c7e56

RESUMEN ORIGINAL:

BACKGROUND: The use of opioids for pain management is often associated with nausea and vomiting. Although conventional antipsychotics are often used to counter emesis, they can be associated with extrapyramidal symptoms. However, chronic pain can induce sleep disturbance. The authors investigated the effects of the atypical antipsychotic olanzapine on morphine-induced emesis and the sleep... + Leer más

BACKGROUND: The use of opioids for pain management is often associated with nausea and vomiting. Although conventional antipsychotics are often used to counter emesis, they can be associated with extrapyramidal symptoms. However, chronic pain can induce sleep disturbance. The authors investigated the effects of the atypical antipsychotic olanzapine on morphine-induced emesis and the sleep dysregulation associated with chronic pain.
METHODS: A receptor binding assay was performed using mouse whole brain tissue. The emetic response in ferrets was evaluated by counting retching and vomiting behaviors. Catalepsy in mice was evaluated by placing both of their forepaws over a horizontal bar. Released dopamine was measured by an in vivo microdialysis study. Sleep disturbance in mice in a neuropathic pain-like state was assayed by electroencephalogram and electromyogram recordings.
RESULTS: Olanzapine showed high affinity for muscarinic M1 receptor in brain tissue. Olanzapine decreased morphine-induced nausea and vomiting in a dose-dependent manner. However, olanzapine at a dose that had an antiemetic effect (0.03 mg/kg) did not induce catalepsy or hyperglycemia. In addition, olanzapine at this dose had no effect on the morphine-induced release of dopamine or inhibition of gastrointestinal transit. Finally, olanzapine inhibited thermal hyperalgesia and completely alleviated the sleep disturbance induced by sciatic nerve ligation.
CONCLUSION: These findings suggest that olanzapine may be useful for the treatment of morphine-induced emesis and as an adjunct for the treatment of neuropathic pain associated with sleep disturbance.

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