[Postherpetic neuralgia alleviated by an SSRI fluvoxamine: two cases of PHN accompanied with depression were treated with fluvoxamine].
Case 1: female, age 76. Fluvoxamine (50 mg/day) initiated a reduction of pain on the 14th day of administration and completely ameliorated pain as well as depression. Case 2: female, age 76. Fluvoxamine (25 mg/day) was administered with tandospirone (15 mg/day) which augments the effect of an SSRI. This combination regimen induced a reduction of PHN-pain on the 10th day and as the analgesic effect attained nearly 50%, there occurred a reflaming of pain on the 35th day. Increasing fluvoxamine to 50 mg/day reameliorated pain on the 49th day, and a further increase to 75 mg/day finally eliminated pain and depression at the end of the 3rd month. The long latency of fluvoxamine action, its shortening by tandospirone and the parallel changes of PHN and depression are all indicative of that the same mechanism, namely renormalization of the dysfunctioned central serotonergic transmission would be underlying both the anti-PHN and antidepressant actions. It would be concluded that fluvoxamine alleviates PHN by restoration of the descending serotonergic inhibition of primary afferent activity that carries pain impulses.
Ohyama
Shiro
S
Chikusuikai Hospital, 1191, Yoshida, Yame, 834-0006 Japan.
Kuniyoshi
Masahiro
M
Nishi
Syogoro
S
Inanaga
Kazutoyo
K
D000368:Aged; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use*; D006562:Herpes Zoster / Q000150:complications*; D006801:Humans; D054833:Isoindoles; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D010879:Piperazines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D016666:Fluvoxamine; D054833:Isoindoles; D010879:Piperazines; D011743:Pyrimidines; D017366:Serotonin Receptor Agonists; D017367:Selective Serotonin Reuptake Inhibitors; C055267:tandospirone