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Papers of the Week

2020 Nov

Psychiatr Danub


Suppl 4

Capsaicin – Potential Solution for Chronic Pain Treatment.


Gašparini D, Ljubičić R, Mršić-Pelčić J
Psychiatr Danub. 2020 Nov; 32(Suppl 4):420-428.
PMID: 33212445.


Chronic pain is a painful condition defined by its duration where pain persists three months or more. Pain is connected with the high price of health care, work inability and disability. Moreover, it has significant consequences for patients and their families, working organizations and the society as a whole. The prevalence of chronic pain can range between 11.0% and 51.3% in general population. Pain is usually coherent with distress and a range of psychological symptoms such as depression, anxiety, altered attention and cognition manifesting as fear. Comprehensive pain management should always include the treatment of associated psychological symptoms. Multidisciplinary approach in treating chronic pain and its comorbidities and proper education of primary care physicians and different specialists involved in the management of chronic pain are crucial for better clinical outcomes. Topical capsaicin acts as a highly selective agonist of transient receptor potential vanilloid 1 of C and Aδ nociceptors. Repeated applications or high concentrations give rise to a long-lasting effect termed defunctionalisation. In addition, the reduction of central sensitization through reduced C-nociceptor input contributes to capsaicin's indirect mechanism of action. Capsaicin provides effective durable pain relief and reduction of intensity and area of pain in adult patients with chronic pain with a faster onset of analgesia and considerably fewer systemic adverse effects than the conventional treatment. While offering high levels of pain relief, additional improvements in sleep, fatigue, depression and quality of life have been noticed. Topical administration avoids dangerous systemic adverse effects and enables the combination with other drugs and analgesics with limited drug-drug interactions. Adding capsaicin to the standard chronic pain treatment might improve, fasten and ease the challenging path of managing chronic pain consequently providing the patient and their society with better quality of life.