Эмоциональные нарушения и их терапия при хронической поясничной боли

Хроническая боль в нижней части спины (ХБНС) – самый частый хронический болевой синдром, который приводит к снижению качества жизни и к нетрудоспособности. У пациентов с ХБНС значимо чаще встречаются тревожные и депрессивные расстройства. Выявлено негативное влияние ХБНС на когнитивные способности и сон. Лечение пациентов с ХБНС следует начинать с немедикаментозных методов, в том числе с образовательной программы, кинезиотерапии, когнитивно-поведенческой терапии. Антидепрессанты назначают при ХБНС для уменьшения выраженности сопутствующих тревожных и депрессивных расстройств, улучшения сна и облегчения боли. Обсуждаются эффективность и безопасность применения сертралина (Серенаты) при ХБНС, его дополнительные нейрохимические механизмы действия в виде влияния на обратный захват дофамина, взаимодействия с сигма-рецепторами, низкая частота побочных эффектов, высокая приверженность пациентов терапии. 

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