Vol. 6, Issue 1, Part A (2024)

Introduction: The triad of depression, anxiety, and chronic pain are widely prevalent and can have adverse impact on patient health, productivity, and quality of life. Dosulepin, a tricyclic antidepressant, is currently being extended for the management of chronic pain. In light of limited data on clinical benefits of dosulepin in chronic pain coexisting with depression/anxiety in the real-world setting, a cross-sectional pan-India survey was conducted to understand neurologists’ opinions on treatment patterns for chronic pain alongside anxiety/depression/sleep issues and their perspectives on clinical outcomes associated with dosulepin use in these patients.
Methods: Fibromyalgia, neuropathic pain, chronic musculoskeletal pain, and chronic headache were the four types of chronic pain assessed. The survey involved 81 neurologists who opined on 17 questions about prevalence, pharmacological treatment and dosulepin use in adolescents, adults, and elderly patients with chronic pain. Descriptive statistics were used to report survey findings.
Results: For adolescents, dosulepin was prescribed by 13.6%, 6.2%, and 11.0% of neurologists for chronic headache, neuropathic pain, and fibromyalgia, respectively. Similarly, dosulepin was prescribed by 12.3% and 17.3% of neurologists for neuropathic pain in adult patients and chronic headache in elderly patients, respectively. Overall, neurologists reported that average time to symptom improvement with dosulepin combinations was shorter than that with combinations without dosulepin regardless of chronic pain type and patient age group. Neurologists’ leading reasons for prescribing dosulepin were better tolerability and faster symptom improvement. Drowsiness, dry mouth, and constipation were the most frequently observed side-effects of dosulepin. 
Conclusion: This survey provides an understanding of the treatment patterns adopted by neurologists in their daily clinical practice when treating patients with chronic pain across different age groups. Neurologists stated better tolerability and faster symptom improvement as reasons for prescribing dosulepin. Nevertheless, future long-term, real-world evidence studies are warranted to support these findings.