Antipsychotics for patients with pain

Sang Wook Shin, Jin Seong Lee, Salahadin Abdi, Su Jung Lee, Kyung Hoon Kim

Research output: Contribution to journalArticle

  • 1 Citations

Abstract

Going back to basics prior to mentioning the use of antipsychotics in patients with pain, the International Association for the Study of Pain (IASP) definition of pain can be summarized as an unpleasant experience, composed of sensory experience caused by actual tissue damage and/or emotional experience caused by potential tissue damage. Less used than antidepressants, antipsychotics have also been used for treating this unpleasant experience as adjuvant analgesics without sufficient evidence from research. Because recently developed atypical antipsychotics reduce the adverse reactions of extrapyramidal symptoms, such as acute dystonia, pseudo-parkinsonism, akathisia, and tardive dyskinesia caused by typical antipsychotics, they are expected to be used more frequently in various painful conditions, while increasing the risk of metabolic syndromes (weight gain, diabetes, and dyslipidemia). Various antipsychotics have different neurotransmitter receptor affinities for dopamine (D), 5-hydroxytryptamine (5-HT), adrenergic (), histamine (H), and muscarinic (M) receptors. Atypical antipsychotics antagonize transient, weak D2 receptor bindings with strong binding to the 5-HT2A receptor, while typical antipsychotics block long-lasting, tight D2 receptor binding. On the contrary, antidepressants in the field of pain management also block the reuptake of similar receptors, mainly on the 5-HT and, next, on the norepinephrine, but rarely on the D receptors. Antipsychotics have been used for treating positive symptoms, such as delusion, hallucination, disorganized thought and behavior, perception disturbance, and inappropriate emotion, rather than the negative, cognitive, and affective symptoms of psychosis. Therefore, an antipsychotic may be prescribed in pain patients with positive symptoms of psychosis during or after controlling all sensory components.

LanguageEnglish (US)
Pages3-11
Number of pages9
JournalKorean Journal of Pain
Volume32
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Antipsychotic Agents
Pain
Antidepressive Agents
Serotonin
Psychotic Affective Disorders
Receptor, Serotonin, 5-HT2A
Psychomotor Agitation
Neurobehavioral Manifestations
Neurotransmitter Receptor
Affective Symptoms
Delusions
Dystonia
Hallucinations
Parkinsonian Disorders
Muscarinic Receptors
Pain Management
Dyslipidemias
Psychotic Disorders
Adrenergic Agents
Histamine

Keywords

  • Antipsychotics
  • D2 receptor antagonists
  • Dopamine
  • Drug related side effects and adverse reactions
  • Extrapyramidal symptom
  • Histamine
  • Pain
  • Prolactin
  • Psychosis
  • Serotonin
  • Weight gain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Shin, S. W., Lee, J. S., Abdi, S., Lee, S. J., & Kim, K. H. (2019). Antipsychotics for patients with pain. Korean Journal of Pain, 32(1), 3-11. https://doi.org/10.3344/kjp.2019.32.1.3

Antipsychotics for patients with pain. / Shin, Sang Wook; Lee, Jin Seong; Abdi, Salahadin; Lee, Su Jung; Kim, Kyung Hoon.

In: Korean Journal of Pain, Vol. 32, No. 1, 01.01.2019, p. 3-11.

Research output: Contribution to journalArticle

Shin, SW, Lee, JS, Abdi, S, Lee, SJ & Kim, KH 2019, 'Antipsychotics for patients with pain', Korean Journal of Pain, vol. 32, no. 1, pp. 3-11. https://doi.org/10.3344/kjp.2019.32.1.3
Shin, Sang Wook ; Lee, Jin Seong ; Abdi, Salahadin ; Lee, Su Jung ; Kim, Kyung Hoon. / Antipsychotics for patients with pain. In: Korean Journal of Pain. 2019 ; Vol. 32, No. 1. pp. 3-11.
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