Revisiting Tramadol: A Multi-Modal Agent for Pain Management.

Abstract:

:Tramadol-an atypical opioid analgesic-has a unique pharmacokinetic and pharmacodynamic profile, with opioidergic, noradrenergic, and serotonergic actions. Tramadol has long been used as a well-tolerated alternative to other drugs in moderate pain because of its opioidergic and monoaminergic activities. However, cumulative evidence has been gathered over the last few years that supports other likely mechanisms and uses of tramadol in pain management. Tramadol has modulatory effects on several mediators involved in pain signaling, such as voltage-gated sodium ion channels, transient receptor potential V1 channels, glutamate receptors, α2-adrenoceptors, adenosine receptors, and mechanisms involving substance P, calcitonin gene-related peptide, prostaglandin E2, and proinflammatory cytokines. Tramadol also modifies the crosstalk between neuronal and non-neuronal cells in peripheral and central sites. Through these molecular effects, tramadol could modulate peripheral and central neuronal hyperexcitability. Given the broad spectrum of molecular targets, tramadol as a unimodal analgesic relieves a broad range of pain types, such as postoperative, low back, and neuropathic pain and that associated with labor, osteoarthritis, fibromyalgia, and cancer. Moreover, tramadol has anxiolytic, antidepressant, and anti-shivering activities that could improve pain management outcomes. The aim of this review was to address these issues in the context of maladaptive physiological and psychological processes that are associated with different pain types.

journal_name

CNS Drugs

journal_title

CNS drugs

authors

Barakat A

doi

10.1007/s40263-019-00623-5

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

481-501

issue

5

eissn

1172-7047

issn

1179-1934

pii

10.1007/s40263-019-00623-5

journal_volume

33

pub_type

杂志文章,评审
  • Cardiovascular effects and risk of syncope related to donepezil in patients with Alzheimer's disease.

    abstract:BACKGROUND:When otherwise unexplained, syncope in patients with Alzheimer's disease may be attributed to bradycardia caused by cholinesterase inhibitors. We studied prospectively the clinical events and cardiovascular changes occurring during treatment with donepezil in patients with Alzheimer's disease. METHODS:Conse...

    journal_title:CNS drugs

    pub_type: 临床试验,杂志文章

    doi:10.2165/00023210-200620050-00005

    authors: Bordier P,Garrigue S,Lanusse S,Margaine J,Robert F,Gencel L,Lafitte A

    更新日期:2006-01-01 00:00:00

  • Hashimoto's encephalopathy : epidemiology, pathogenesis and management.

    abstract::Hashimoto's encephalopathy is a term used to describe an encephalopathy of presumed autoimmune origin characterised by high titres of antithyroid peroxidase antibodies. In a similar fashion to autoimmune thyroid disease, Hashimoto's encephalopathy is more common in women than in men. It has been reported in paediatric...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200721100-00002

    authors: Mocellin R,Walterfang M,Velakoulis D

    更新日期:2007-01-01 00:00:00

  • Selection criteria for the clinical use of the newer antiepileptic drugs.

    abstract::In recent years, several new antiepileptic drugs (AEDs) have been licensed: felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate, vigabatrin and zonisamide. These drugs have proven efficacy as add-on therapy in patients with difficult-to-treat partial epilepsy, as 20-50% of patients ...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200317060-00003

    authors: Deckers CL,Knoester PD,de Haan GJ,Keyser A,Renier WO,Hekster YA

    更新日期:2003-01-01 00:00:00

  • Tardive Dyskinesia Associated with Atypical Antipsychotics: Prevalence, Mechanisms and Management Strategies.

    abstract::All antipsychotics, including the atypical antipsychotics (AAPs), may cause tardive dyskinesia (TD), a potentially irreversible movement disorder, the pathophysiology of which is currently unknown. The prevention and treatment of TD remain major challenges for clinicians. We conducted a PubMed search to review the pre...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-018-0494-8

    authors: Stegmayer K,Walther S,van Harten P

    更新日期:2018-02-01 00:00:00

  • Assessment of Clinically Meaningful Improvements in Self-Reported Walking Ability in Participants with Multiple Sclerosis: Results from the Randomized, Double-Blind, Phase III ENHANCE Trial of Prolonged-Release Fampridine.

    abstract:BACKGROUND:Walking impairment is a hallmark of multiple sclerosis (MS). It affects > 90% of individuals over time, reducing independence and negatively impacting health-related quality of life, productivity, and daily activities. Walking impairment is consistently reported as one of the most distressing impairments by ...

    journal_title:CNS drugs

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s40263-018-0586-5

    authors: Hobart J,Ziemssen T,Feys P,Linnebank M,Goodman AD,Farrell R,Hupperts R,Blight AR,Englishby V,McNeill M,Chang I,Lima G,Elkins J,ENHANCE study investigators.

    更新日期:2019-01-01 00:00:00

  • Affective disorders in patients with HIV infection: impact of antiretroviral therapy.

    abstract::At the beginning of the AIDS pandemic, affective disorders (such as depressed mood) were seen in a considerable number of HIV-1-infected individuals. These disorders were a result of the poor physical condition of the patients, brain involvement by the virus (e.g. encephalopathy) or a reaction to disadvantageous livin...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200620060-00005

    authors: Arendt G

    更新日期:2006-01-01 00:00:00

  • The new generation of GABA enhancers. Potential in the treatment of epilepsy.

    abstract::gamma-Aminobutyric acid (GABA) is considered to be the major inhibitory neurotransmitter in the brain and loss of GABA inhibition has been clearly implicated in epileptogenesis. GABA interacts with 3 types of receptor: GABAA, GABAB and GABAC. The GABAA receptor has provided an excellent target for the development of d...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200115050-00001

    authors: Czuczwar SJ,Patsalos PN

    更新日期:2001-01-01 00:00:00

  • A single-dose pilot trial of intranasal rapid-acting insulin in apolipoprotein E4 carriers with mild-moderate Alzheimer's disease.

    abstract:INTRODUCTION:Intranasal (IN) insulin acutely improves verbal memory in mild cognitive impairment (MCI)/Alzheimer's disease (AD), but its therapeutic effects may be attenuated in apolipoprotein E4 (ApoE4) carriers. Furthermore, rapid-acting (RA) insulins may have superior therapeutic effects compared with regular insuli...

    journal_title:CNS drugs

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s40263-014-0214-y

    authors: Rosenbloom MH,Barclay TR,Pyle M,Owens BL,Cagan AB,Anderson CP,Frey WH 2nd,Hanson LR

    更新日期:2014-12-01 00:00:00

  • Nusinersen: A Review in 5q Spinal Muscular Atrophy.

    abstract::Spinal muscular atrophy (SMA) is a rare autosomal recessive neuromuscular disorder most commonly caused by a deletion or mutation in the survival motor neuron 1 (SMN1) gene, which leads to insufficient levels of survival motor neuron (SMN) protein. In such patients, SMN protein production relies on the SMN2 gene. Nusi...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-018-0545-1

    authors: Hoy SM

    更新日期:2018-07-01 00:00:00

  • Clinical issues in use of atypical antipsychotics for depressed patients.

    abstract::Major depressive disorder (MDD) is a chronic, recurrent mental disease that causes serious disability. Because currently available antidepressants have limited efficacy with respect to response and remission in patients with MDD, clinicians must choose the best available treatment interventions for patients who do not...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-012-0032-z

    authors: Pae CU,Patkar AA

    更新日期:2013-05-01 00:00:00

  • Correction to: Oral Disease-Modifying Treatments for Relapsing Multiple Sclerosis: A Likelihood to Achieve No Evidence of Disease Activity or Harm Analysis.

    abstract::NEDA was evaluated as the proportion of patients free of relapses, 3-month confirmed disability progression, and free of new or newly enlarging T2 lesion and Gadolinium enhancing lesions. ...

    journal_title:CNS drugs

    pub_type: 已发布勘误

    doi:10.1007/s40263-018-0595-4

    authors: Papadopoulos D,Mitsikostas DD

    更新日期:2019-01-01 00:00:00

  • Pharmacological management of neuropathic pain following spinal cord injury.

    abstract::Spinal cord injury (SCI) has a number of severe and disabling consequences, including chronic pain, and around 40% of patients develop persistent neuropathic pain. Pain following SCI has a detrimental impact on the patient's quality of life and is a major specific healthcare problem in its own right. Thus far, there i...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200822060-00002

    authors: Baastrup C,Finnerup NB

    更新日期:2008-01-01 00:00:00

  • The Therapeutic Role of Gangliosides in Neurological Disorders.

    abstract::Numerous in vitro and in vivo experimental animal studies have demonstrated that gangliosides, particularly GMI ganglioside (siagoside), may stimulate or accelerate the repair of peripheral and central nervous system neurons after various types of damage. Clinical studies of GMl in peripheral neuropathies and stroke, ...

    journal_title:CNS drugs

    pub_type: 杂志文章

    doi:10.2165/00023210-199401030-00006

    authors: Schneider JS

    更新日期:1994-03-01 00:00:00

  • Role of the melatonin system in the control of sleep: therapeutic implications.

    abstract::The circadian rhythm of pineal melatonin secretion, which is controlled by the suprachiasmatic nucleus (SCN), is reflective of mechanisms that are involved in the control of the sleep/wake cycle. Melatonin can influence sleep-promoting and sleep/wake rhythm-regulating actions through the specific activation of MT(1) (...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200721120-00004

    authors: Pandi-Perumal SR,Srinivasan V,Spence DW,Cardinali DP

    更新日期:2007-01-01 00:00:00

  • Therapeutic monitoring of antiepileptic drugs during pregnancy and in the postpartum period: is it useful?

    abstract::As in all patient populations, epilepsy is common in pregnant women. Consequently, approximately 1 in 200 pregnancies is exposed to antiepileptic drugs (AEDs). Although exposure to AEDs in utero has been associated with an increased risk of major fetal malformations, most women with epilepsy require medication through...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200620100-00001

    authors: Adab N

    更新日期:2006-01-01 00:00:00

  • Adjunctive Cenobamate for Focal-Onset Seizures in Adults: A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND:Cenobamate is a novel tetrazole-derived carbamate compound with a dual mechanism of action. This drug can enhance the inactivated state of voltage-gated sodium channels, preferentially inhibiting the persistent component of the sodium channel current, and acts as a positive allosteric modulator of GABAA rece...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-020-00759-9

    authors: Lattanzi S,Trinka E,Zaccara G,Striano P,Del Giovane C,Silvestrini M,Brigo F

    更新日期:2020-11-01 00:00:00

  • Anticonvulsant hypersensitivity syndrome in children: incidence, prevention and management.

    abstract::Anticonvulsant hypersensitivity syndrome (AHS) is a rare, but potentially fatal, adverse reaction that occurs in patients, including children, who are treated with anticonvulsants. During metabolism of the anticonvulsant, toxic arene-oxide compounds are produced. AHS is associated with both cutaneous and systemic symp...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200216030-00006

    authors: Verrotti A,Trotta D,Salladini C,Chiarelli F

    更新日期:2002-01-01 00:00:00

  • Pharmacotherapy for Friedreich ataxia.

    abstract::Friedreich ataxia (FA) is a progressive genetic neurological disorder associated with degeneration of the dorsal columns, spinocerebellar tracts and other regions of the nervous system. The disorder results from mutations in the gene referred to as FXN. Almost all mutations are expansions of an intronic GAA repeat in ...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200923030-00003

    authors: Tsou AY,Friedman LS,Wilson RB,Lynch DR

    更新日期:2009-01-01 00:00:00

  • Treatment Options for Narcolepsy.

    abstract::Narcolepsy type 1 and narcolepsy type 2 are central disorders of hypersomnolence. Narcolepsy type 1 is characterized by excessive daytime sleepiness and cataplexy and is associated with hypocretin-1 deficiency. On the other hand, in narcolepsy type 2, cerebrospinal fluid hypocretin-1 levels are normal and cataplexy ab...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-016-0337-4

    authors: Barateau L,Lopez R,Dauvilliers Y

    更新日期:2016-05-01 00:00:00

  • Short-term effect of low-dose atorvastatin on haemorrheological parameters, platelet aggregation and endothelial function in patients with cerebrovascular disease and hyperlipidaemia.

    abstract:INTRODUCTION AND OBJECTIVE:Haemorrheological parameters and endothelial function are known to be altered in vascular diseases, including stroke. Treatment with HMG-CoA reductase inhibitors ('statins') improves cerebrovascular (and cardiovascular) morbidity and mortality in patients with atherosclerosis; the beneficial ...

    journal_title:CNS drugs

    pub_type: 杂志文章

    doi:10.2165/00023210-200418030-00003

    authors: Szapary L,Horvath B,Marton Z,Alexy T,Kesmarky G,Habon T,Szots M,Koltai K,Juricskay I,Czopf J,Toth K

    更新日期:2004-01-01 00:00:00

  • Luteal phase administration of agents for the treatment of premenstrual dysphoric disorder.

    abstract::This review focuses on current information about luteal phase administration (i.e. typically for the last 2 weeks of the menstrual cycle) of pharmacological agents for the treatment of premenstrual dysphoric disorder (PMDD). Compared with continuous administration, a luteal phase administration regimen reduces the exp...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00023210-200418070-00004

    authors: Freeman EW

    更新日期:2004-01-01 00:00:00

  • Mirtazapine : A Review of its Pharmacology and Therapeutic Potential in the Management of Major Depression.

    abstract:SYNOPSIS:Mirtazapine is a tetracyclic antidepressant with a novel mechanism of action; it increases noradrenergic and serotonergic neurotransmission via blockade of central α2-adrenergic auto- and heteroreceptors. The increased release of serotonin (5-hydroxytryptamine; 5-HT) stimulates serotonin 5-HT1 receptors becaus...

    journal_title:CNS drugs

    pub_type: 杂志文章

    doi:10.2165/00023210-199605050-00007

    authors: Davis R,Wilde MI

    更新日期:1996-05-01 00:00:00

  • Neuropsychiatric adverse events associated with statins: epidemiology, pathophysiology, prevention and management.

    abstract::Statins, or 3-hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitors, such as lovastatin, atorvastatin, simvastatin, pravastatin, fluvastatin, rosuvastatin and pitavastatin, are cholesterol-lowering drugs used in clinical practice to prevent coronary heart disease. These drugs are generally well tolerated and have ...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-013-0135-1

    authors: Tuccori M,Montagnani S,Mantarro S,Capogrosso-Sansone A,Ruggiero E,Saporiti A,Antonioli L,Fornai M,Blandizzi C

    更新日期:2014-03-01 00:00:00

  • Newly Approved Agents for the Treatment and Prevention of Pediatric Migraine.

    abstract::Treatment of pediatric migraine remains an unmet medical need. There continues to be a paucity of pediatric randomized controlled trials for the treatment of migraine, both in the acute and preventive settings. Pediatric studies are often complicated by high placebo-response rates and much of our current practice is b...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-016-0375-y

    authors: Kacperski J,Hershey AD

    更新日期:2016-09-01 00:00:00

  • Efficacy and tolerability of zolmitriptan oral tablet in the acute treatment of menstrual migraine.

    abstract:OBJECTIVE:To determine the efficacy and tolerability of zolmitriptan 2.5 mg oral tablet as an acute treatment for menstrual migraine attacks. METHODS:This was a two-phase, multicentre, randomised, double-blind, placebo-controlled, parallel-group outpatient study (Phase I is reported here). The study was conducted at 2...

    journal_title:CNS drugs

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.2165/00023210-200620120-00005

    authors: Tuchman M,Hee A,Emeribe U,Silberstein S

    更新日期:2006-01-01 00:00:00

  • Attention-deficit/hyperactivity disorder with inadequate response to stimulants: approaches to management.

    abstract::Attention-deficit/hyperactivity disorder, or ADHD, is the most frequently occurring neurobiological disorder in childhood and is defined by symptoms of inattention and/or hyperactivity and impulsivity that are excessive when compared with other individuals at the same developmental level. ADHD can be successfully trea...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-013-0130-6

    authors: Childress AC,Sallee FR

    更新日期:2014-02-01 00:00:00

  • Antimicrobial Use in Patients with Dementia: Current Concerns and Future Recommendations.

    abstract::Infections are common in people with dementia, and antibiotic use is widespread, albeit highly variable, across healthcare settings and countries. The few studies conducted to date that consider the appropriateness of antibiotic prescribing specifically for people with dementia focus on people with advanced dementia a...

    journal_title:CNS drugs

    pub_type: 杂志文章

    doi:10.1007/s40263-017-0427-y

    authors: Parsons C,van der Steen JT

    更新日期:2017-06-01 00:00:00

  • Current and Emerging Treatment Strategies for Neuronal Ceroid Lipofuscinoses.

    abstract::The neuronal ceroid lipofuscinoses comprise a group of neurodegenerative lysosomal storage disorders caused by mutations in at least 13 different genes and primarily affect the brain and the retina of children or young adults. The disorders are characterized by progressive neurological deterioration with dementia, epi...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-019-00620-8

    authors: Kohlschütter A,Schulz A,Bartsch U,Storch S

    更新日期:2019-04-01 00:00:00

  • Cognitive effects of statin medications.

    abstract::The demonstrated benefits of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) for cardiovascular and cerebrovascular disease are well established in the medical literature, and this class of medications is among those most commonly prescribed in the USA. In 2012, the US Food and Drug Admi...

    journal_title:CNS drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40263-014-0147-5

    authors: Kelley BJ,Glasser S

    更新日期:2014-05-01 00:00:00

  • Cost effectiveness of pharmacotherapy for the prevention of migraine: a Markov model application.

    abstract:BACKGROUND:There are few data about the cost effectiveness of prophylactic medications for migraine. Clinical trials have shown several preventive agents to be useful in reducing the frequency of migraine attack while having tolerable side effects. OBJECTIVE:To compare the cost effectiveness of adding preventive treat...

    journal_title:CNS drugs

    pub_type: 杂志文章

    doi:10.2165/11531180-000000000-00000

    authors: Yu J,Smith KJ,Brixner DI

    更新日期:2010-08-01 00:00:00