INFLUENCE OF DULOXETINE ON THE CLINICAL COURSE AND BIOCHEMICAL PARAMETERS IN PATIENTS WITH CHRONIC VERTEBROGENIC LUMBOSACRAL PAIN SYNDROMES
DOI:
https://doi.org/10.11603/mcch.2410-681X.2023.i3.14128Keywords:
chronic lumbosacral pain syndromes, duloxetine, substance P, cortisolAbstract
Introduction. Chronic lower back pain is a source of suffering for millions of individuals and a leading cause of disability in developed countries. Unfortunately, there is currently no consensus on the pathogenesis of chronic pain, and a standardized, sequential approach to treatment remains elusive. The development of chronic pain is a complex and multifaceted process influenced by various factors. This article analyzes the clinical course of pain syndrome, assesses levels of depression, anxiety, and quality of life, and evaluates levels of substance P and cortisol in the blood among patients undergoing duloxetine treatment
The aim of the study – to assess the impact of duloxetine on the clinical course and biochemical parameters in patients with chronic vertebrogenic lumbosacral pain syndromes (VLSPS) following comprehensive inpatient treatment.
Research Methods. A comprehensive clinical examination and determination of biochemical markers (cortisol and substance P) in serum were conducted in 45 patients (average age 41.2±11.2 years, 26 males (57.7 %), 19 females (42.3 %)). Biochemical markers were determined using the enzyme-linked immunosorbent assay method without extraction in serum samples.
Results and Discussion. After 8 weeks of daily administration of duloxetine at a dose of 60 mg in patients with chronic VLSPS, the severity of pain syndrome decreased, and the likelihood of clinical symptoms (muscle tension, antalgic scoliosis, Lasegue's sign) significantly decreased (p<0.05). The mobility of the lumbar spine improved according to the finger-to-floor test results, from (23.12±2.31) cm to (16.46±2.26) cm. Anxiety and depression scores decreased significantly, and quality of life improved (p<0.05). The level of substance P in the blood decreased from (8.25±2.35) ng/ml to (6.11±2.71) ng/ml, while cortisol levels decreased from (379.3±93.1) nmol/L to (212.2±88.0) nmol/L (p>0.05).
Conclusions. Prescribing duloxetine after completing inpatient treatment in patients with chronic VLSPS leads to improvements in clinical metrics, as well as a reduction in cortisol and substance P levels in the blood.
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