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Using Antidepressants to Treat Pain

September 8th, 2014 · No Comments

Welcome to the series Why You Should See a Pain Management Psychiatrist.

Let’s look at using psychiatric medication for pain.

Antidepressants are, obviously, best know for treating depression. But there’s more! Antidepressants can be used for chronic pain itself, separately from treating depression. This means they are sometimes prescribed even if someone has no depression – just to treat pain itself. Let’s look at 3 different categories of antidepressants used to treat pain.

1. SNRI (Serotonin-norepinephrine reuptake inhibitors) Dual-action antidepressants, those that work on both the serotonin and norepinephrine systems, help with pain. An example is Cymbalta, which is helpful in both diabetic peripheral neuropathy and fibromyalgia, and Savella, which is approved for fibromyalgia.

2. Tricyclics (TCAs) These are older antidepressants which help in many different pain disorders. In fact, they are the most-studied antidepressants for pain. However, even though they work, they are not FDA-approved to treat pain. Examples include Amitriptyline (Elavil) and Nortriptyline (Pamelor).

3. SSRIs (Selective serotonin reuptake inhibitors) There is some evidence, thought research has been mixed, that SSRIs help with headaches, both migraines and chronic daily headache.

Overall, antidepressants are sometimes helpful in treating pain itself. As we know, pain often exists along with depression and anxiety, so these medications can be a good choice when psychiatric symptoms are present along with pain. Using 1 medication for multiple symptoms is a good idea. An important point to remember is that if your doctor recommends an antidepressant, it doesn’t mean that your pain is “”in your head” or that you’re simply imagining your pain.

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