title: An intricate relationship between pain and depression: clinical correlates, coactivation factors and therapeutic targets.
abstract: BACKGROUND
  An apparent clinical relationship between pain and depression has long been recognized, which makes an enormous impact on the individual health care. At present, the practical implication of such overlapping symptomatology between pain and depression is not clear, but the prevalence estimates for depression are substantially inflated among patients with chronic pain and vice versa. This interaction has been labeled as the depression-pain syndrome or depression-pain dyad.
  
  
  METHODS
  This article discusses the neurobiological substrates and neuroanatomical pathways involved in pain-depression dyad along with newer therapeutic targets.
  
  
  CONCLUSIONS
  Several key themes emerged from our review of the relationship between depression and pain. First, the diagnosis of depression in pain or vice versa is particularly challenging, and the development of better diagnostic framework that involves both pain and depression is particularly required. Secondly, the entwined relationship between pain and depression supports the possibility of common coactivating factors that results in their neurophysiological overlap. A broad understanding of the role played by the central nervous system (CNS) in the processing of pain and depression may eventually lead to the introduction of triple reuptake inhibitors, agomelatine, vilazodone and ketamine with novel mechanism of action, hence appear to be of promising potential for pain with depression.
authors.affiliation: Panjab University, University Institute of Pharmaceutical Sciences, UGC Centre of Advanced Study, Pharmacology Research Laboratory , Chandigarh-160 014 , India +91 172 2534105 ; +91 172 2541142 ; dr_chopra_k@yahoo.com.
authors.forename: Kanwaljit
authors.initials: K
authors.lastname: Chopra
authors.forename: Vipin
authors.initials: V
authors.lastname: Arora
mesh_terms: D000818:Animals; D003863:Depression / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D010146:Pain / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology