title: An open and double-blind cross-over study on the efficacy of clomipramine (Anafranil) in patients with painful mono- and polyneuropathies.
abstract: 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.
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002422:Causalgia / Q000188:drug therapy; D002986:Clinical Trials as Topic; D002997:Clomipramine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy; D009443:Neuritis / Q000188:drug therapy*; D010591:Phantom Limb / Q000188:drug therapy; D011115:Polyneuropathies / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D002997:Clomipramine; D001241:Aspirin