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International audience; Neuropathic pain is defined as pain caused by a lesion or a disease affecting the somatosensory nervous system. Development of neuropathic pain is induced by many pathophysiological mechanisms affecting pain pathways. Neuropathic pain has diverse origins, making its management difficult, hence, many patients with neuropathic pain do not receive appropriate treatment. In 2015, a revision of the Neuropathic Pain Special Interest Group's (NeuPSIG) previous recommendations, based on a systematic review and meta-analysis, evaluated the efficacy of systemic and topical treatments of neuropathic pain. Treatments lines were established using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), which allows to rate the quality of evidence and the strength of recommendations. First line treatments are gabapentin and pregabalin, noradrenalin and serotonin reuptake inhibitors and tricyclic antidepressants. Capsaicin and lidocaine patches are second line treatments, tramadol and strong opioids are third line treatments. This work also highlighted molecules with inconclusive recommendations or non-recommended pharmacological treatments based on a low quality of evidence, a lack of efficacy or a bad safety profile. The objective of this paper is to present the different treatments and to detail their mechanisms of action.

Switching antidepressant medication may be helpful in depressed patients a having no benefit from the initial antidepressant treatment. a Before considering switching strategy, the initial antidepressant a treatment should produce no therapeutic effect after at least 4 weeks of a administration at adequate dosage. a Choosing an antidepressant of pharmacologically distinct profile fails a to consistently demonstrate a significant superiority in terms of a effectiveness over the switching to another antidepressant within the a same pharmacological class. a Augmenting SSRI/SNRIs with mirtazapine/mianserin has become the most a recommended strategy of antidepressant combinations. a Augmenting SSRI with tricyclic drugs is now a less recommended strategy a of antidepressant combinations given the increased risk for the a occurrence of pharmacokinetic drug-drug interactions and adverse a effects.

Le trouble obsessionnel-compulsif (TOC) est une maladie psychique fréquente et invalidante tant pour la personne qui en souffre que pour son entourage. Différents modèles étiologiques se sont succédé au cours de l’histoire de la psychiatrie, essayant d’expliquer la symptomatologie obsessionnelle-compulsive d’un point de vue psychique, comportemental ou biologique. Cette revue a pour but de présenter les différents modèles étiologiques du TOC ainsi que d’en décrire les aspects cliniques et thérapeutiques., Obsessive compulsive disorder (OCD) is a frequent and disabling psychic illness. Along psychiatric history, several etiological models have been successively hypothesized to explain the obsessive compulsive symptoms from a psychological, behavioural or biological point of view. This review aims at presenting OCD etiological models as well as describing OCD clinical and therapeutic aspects.

Le trouble obsessionnel-compulsif (TOC) est une maladie fréquente et débilitante caractérisée par la présence d'obsessions et/ou de compulsions. Ce trouble entraîne une détresse importante tant pour la personne qui en souffre que pour son entourage. Le diagnostic, avant tout clinique, peut s'appuyer sur différentes échelles d'évaluation. Bien que plusieurs hypothèses étiopathogéniques existent et que différents traitements soient proposés, la physiopathologie de ce trouble reste encore largement incomprise. Le but de cette revue est de synthétiser les dernières avancées en matière de physiopathologie du TOC., Obsessive compulsive disorder (OCD) is a frequent and disabling psychic illness. Along psychiatric history, several etiological models have been successively hypothesized to explain the obsessive compulsive symptoms from a psychological, behavioural or biological point of view. This review aims at presenting OCD etiological models as well as describing OCD clinical and therapeutic aspects.