Sunday, March 26, 2017

Chronic pain and depression are linked by brain gene changes | New Scientist

People who have chronic pain are more likely to experience mood disorders, but it's not clear how this happens. Now a study in mice has found that chronic pain can induce genetic changes in brain regions that are linked to depression and anxiety, a finding that may lead to new treatments for pain.

"At least 40 per cent of patients who suffer from severe forms of chronic pain also develop depression at some point, along with other cognitive problems," says Venetia Zachariou of the Icahn School of Medicine at Mount Sinai in New York.

To see if there might be a genetic link between these conditions, Zachariou and her team studied mice with damage to their peripheral nervous system. These mice show symptoms similar to chronic pain in people – they become hypersensitive to harmless touch, and avoid other situations that might also cause them pain.

Until now, pain behaviour in mice had only been studied for at most a week at a time, says Zachariou, whose team monitored their mice for 10 weeks. "At the beginning, we saw only sensory deficits and pain-like symptoms. But several weeks later, the animals developed anxiety and depression-like behaviours."

The team then examined gene activity in three regions in the mouse brains we know are associated with depression and anxiety. Analysing the nucleus accumbens, medial prefrontal cortex, and periaqueductal gray, they found nearly 40 genes where activity was significantly higher or lower than in mice without the nervous system damage.

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https://www.newscientist.com/article/2125680-chronic-pain-and-depression-are-linked-by-brain-gene-changes/

Sunday, March 19, 2017

Rapid Shift to Long-term Opioid Use After Initial Prescription - Medscape

For patients who need an initial opioid prescription, supplying 3 or fewer days' worth of medication reduces the likelihood of long-term opioid use, new data show.

In a large representative sample of opioid-naive, cancer-free adults who received a first prescription for opioid pain relievers, the likelihood of long-term opioid use increased with each additional day of medication supplied, starting with the third day, the study team found.

"Knowledge that the risks for chronic opioid use increase with each additional day supplied might help clinicians evaluate their initial opioid prescribing decisions and potentially reduce the risk for long-term opioid use," the authors, led by Bradley Martin, PharmD, PhD, at the University of Arkansas for Medical Sciences in Little Rock, write.

"Discussions with patients about the long-term use of opioids to manage pain should occur early in the opioid prescribing process," they advise in the Morbidity and Mortality Weekly Report of March 17.

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http://www.medscape.com/viewarticle/877354

Friday, March 03, 2017

NYTimes: How to Block Out Pain

Pain is a personal experience, and success comes from self-management," says David Tauben, clinical professor in the department of pain medicine at the University of Washington. Respond to pain calmly — worry and fear activate the neural pathways through which pain travels and can amplify the sensations that cause it in the first place. Because pain has both mental and physical components, some researchers who study it combine psychology with the physical effects. "Be careful of negative thoughts and worrying," Tauben says. "If it's difficult to control them, find a professional to help you, like a psychologist or counselor."


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