Table 1.
Analgesic and antipruritic effect of psychotropic drugs on different types of pain/itching.
| Drug | Analgesic Effect: Animal Models | Analgesic Effect: Clinical Trial | Antipruritic Effect: Animal Models | Antipruritic Effect: Clinical Trial | Dosage in Clinical Trials, Literature Data (Our Study) | Main Side Effects Led to Withdrawals and Refusal of Treatment |
|---|---|---|---|---|---|---|
| Tianeptine | formalin test; mechanical allodynia; fibromyalgia | chronic pain in patients with chronic renal failure (CRF) | ND | neuropathic pruritus in male patients with CRF | 20–40 mg/day (37.5 mg/day) |
ND * |
| Citalopram | hot plate test; the second phase of the formalin test; thermal hypersensitivity in the chronic constriction injury (CCI) model | psychosomatic pain; diabetic neuropathy (mild effect); migraine (presumably); neuropathic pain in patients with CRF (mild effect) | ND | itching in psoriasis (mild effect); neuropathic pruritus in patients with CRF (mild effect) | 20–40 mg/day (20 mg/day) |
nausea, vomiting, epileptic seizures, tachycardia, dizziness, gastric upset, diarrhea |
| Mianserin | hot plate test (enhancement of metamizol); tail flick test (enhancement of metamizole and indometacin); diabetic neuropathy | neuropathic pain in patients with CRF; tension headache; chronic pain associated with “true” depression | potentiation of hindlimb scratching | neuropathic pruritus in male patients with CRF | 30–90 mg/day (30 mg/day) |
lack of appetite, dryness of mouth, thirst, drowsiness, dullness |
| Carbamazepine | hot plate test; inflammatory pain; trigeminal neuralgia; chemotherapy-induced painful neuropathy | diabetic neuropathy; trigeminal neuralgia | ND | itching in sclerosis; brachioodal itch; trigeminal trophic syndrome | 200–800 mg/day (300 mg/day) |
giddiness, rash, sleeplessness |
| Trazodone | hot plate test; thermal hyperalgesia; formalin induced pain | diabetic neuropathy; adjuvant therapy in fibromyalgia | ND | diffuse pruritus | 50–300 mg/day (50–100 mg/day) |
dizziness, headache, tachycardia, stomachache |
| Chlorprothixene | anesthesia of experimental animals | postherpetic neuralgia; adjuvant therapy in meralgia paraesthetica | ND | diffuse pruritus | 50–400 mg/day (15 mg/day) |
psychical abnormalities, drowsiness, vertigo |
| Venlafaxine | hyperalgesia in the CCI model; carrageenan-induced pain and inflammation; mechanical hypersensitivity induced by SNI; neuroinflammation and oxidative stress | diabetic neuropathy; chemotherapy-induced peripheral neuropathy; visceral hyperalgesia; inflammation | ND | ND | 37.5–225 mg/day | nausea, somnolence, headache, insomnia, sexual dysfunction, dizziness |
“ND”—no data, *—there are no data about side effects of tianeptine in experiments on its analgesic/antipruritic efficacy, but the drug has neurologic, cardiovascular, and gastrointestinal side effects as an antidepressant.