Affective spectrum disorders include mood
and anxiety disorders, while term
functional somatic syndrome describes disorders with chronic pain as dominant
symptom, without patognomonic tissue damage, such as fibromialgia, irritable bowel
syndrome, headache. Hypothesis of central neuropathic pain explains possibility of descendent inhibitor mechanism of pain deficiency, including noradrenergic
and serotonergic projections, or possibility that central suprasegmental sensitisation within the nociceptive pathway, triggered by emotional stressors can caused pain
symptoms in both. Serotonergic
and noradrenergic pathways
and voltage sensitive channels are include in that mechanism. Modern psychopharmacology can improve treatment fot both. Therapeutic action of SSRI's, SNRI's
and alfa 2 delta lig
ands succesfully can increase neurotransmission in malfunctioning CNS pathways
and reduce
symptoms.
Our clinical trial was conducted during 2013/2014. with 57 patient 32 female, 25 male, diagnosed as tension headache, without brain damage or disease, with depressive symptoms.
Aim of the trial was to explore usefulness of antidepressant treatment for one of the common functional somatic syndromes as headache. Diagnostic instruments used were HAM-D 17, CGI, personal diary with registered frequency of headache attakcs were sour documents also. Patient treated with fluoxetine 20 mg daily, during 6 month and instructed to use personal diaries to. Diagnostic instruments were used at base line and after the treatment, when diaries reviewed also. Results showed that iimprovement in scores at HAM-D and CGI's scales was remarkable and frequency of headache attacks lowered. Conclusion was that antidepressants can bee effective in an typical functional somatic syndrome and can improve therapeutic approaches for remarkable large group of patients.
