{"id":6038,"date":"2014-05-05T06:45:09","date_gmt":"2014-05-05T10:45:09","guid":{"rendered":"http:\/\/www.howtocopewithpain.org\/blog\/?p=6038"},"modified":"2025-09-04T14:06:58","modified_gmt":"2025-09-04T18:06:58","slug":"medications-for-pain-series-antidepressants-2","status":"publish","type":"post","link":"https:\/\/www.howtocopewithpain.org\/blog\/6038\/medications-for-pain-series-antidepressants-2\/","title":{"rendered":"Medications for Pain Series:  <i>Antidepressants<\/i>"},"content":{"rendered":"<p style=\"text-align: center;\"><em>This article is one in a series on <strong>Medications for Pain<\/strong>. What are your choices? How do various medications work? What are the pros and cons? How about side effects?<\/em><\/p>\n<p><strong><em>Antidepressants<\/em><\/strong> are medications originally used to treat depression or anxiety, and which\u00a0are also good for\u00a0pain. Within this class, there are:<\/p>\n<ul>\n<li><strong>Tricyclic antidepressants (TCAs)<\/strong>, which include Amitriptyline (Elavil) and Nortriptyline.<\/li>\n<li><strong>SNRIs <\/strong>(Serotonin-Norepinephrine Reuptake Inhibitors), which include Cymbalta,\u00a0Effexor (specifically at higher\u00a0doses), and\u00a0Savella.<\/li>\n<li><strong>SSRIs <\/strong>(Selective Serotonin Reuptake Inhibitors), which include Zoloft, Prozac, Lexapro, etc.<\/li>\n<\/ul>\n<p>It&#8217;s important to know\u00a0that antidepressants work for pain <em>even if<\/em> you&#8217;re not depressed or anxious. They have\u00a0an <em>independent<\/em> pain-reducing effect. So if your physician recommends an antidepressant, that doesn&#8217;t mean that\u00a0your pain is all in your head, or that you&#8217;re just anxious or depressed.<\/p>\n<p>That being said, anxiety and depression often go along with chronic pain, unfortunately. So if that&#8217;s true for you, a good thing about these medications is that they also help depression, anxiety and PTSD (Post Traumatic Stress Disorder;\u00a0PTSD\u00a0can occur if there was\u00a0a traumatic cause to your pain, such as\u00a0a car or work accident). As well, because sedation is a common side effect of some\u00c2\u00a0antidepressants,\u00a0they\u00a0can help the sleep disturbance that accompanies pain.<\/p>\n<p><strong>Effect of Antidepressants:<\/strong> All antidepressants work to change neurotransmitters in the brain. Neurotransmitters are those chemicals by which nerves communicate with one another. TCAs and SNRIs increase both serotonin and norepinephrine, while SSRIs only increase serotonin. TCAs also affect many other chemical systems, so can cause many other side effects such as\u00a0dry mouth, constipation, sedation, and\u00a0cardiac and blood pressure effects.<\/p>\n<p>It seems that the <em>combination <\/em>of serotonin and norepinephrine effect is what&#8217;s crucial in decreasing pain.<\/p>\n<p><strong>Medical Studies:<\/strong><\/p>\n<ul>\n<li><strong>TCAs<\/strong>: Out of 126 studies of TCAs for pain, 95% of the studies showed that TCAs were effective for reducing pain.<\/li>\n<li><strong>SNRIs<\/strong>: Out of 10 studies, 100%\u00a0showed that SNRIs were effective.<\/li>\n<li><strong>SSRIs<\/strong>: Of 39 studies, 33% showed that SSRIs were effective.<\/li>\n<\/ul>\n<p>So again, this demonstrates that the medications which affect <em>both <\/em>serotonin and norepinephrine work best at helping with pain.<\/p>\n<p><strong>Uses of Antidepressants:<\/strong> Let&#8217;s look at some examples of these medications for specific pain disorders. Cymbalta is\u00a0FDA-approved to treat the pain that can accompany diabetes, called Diabetic Peripheral Neuropathy. Savella is approved for Fibromyalgia. Paxil is helpful for chronic daily headache and migraines. We do know that SSRIs are generally not helpful for neuropathic (nerve) pain.<\/p>\n<p><strong>Common Side Effects:<\/strong><\/p>\n<ul>\n<li><strong>TCAs<\/strong>: sedation, constipation, weight gain; less often\u00a0heart arrhythmia, decreased blood pressure<\/li>\n<li><strong>SNRIs<\/strong>: nausea, sedation<\/li>\n<li><strong>SSRIs<\/strong>: headache, nausea<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>This article is one in a series on Medications for Pain. What are your choices? How do various medications work? What are the pros and cons? How about side effects? Antidepressants are medications originally used to treat depression or anxiety, and which\u00a0are also good for\u00a0pain. Within this class, there are: Tricyclic antidepressants (TCAs), which include [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6038","post","type-post","status-publish","format-standard","hentry","category-1"],"_links":{"self":[{"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/posts\/6038","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/comments?post=6038"}],"version-history":[{"count":4,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/posts\/6038\/revisions"}],"predecessor-version":[{"id":8038,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/posts\/6038\/revisions\/8038"}],"wp:attachment":[{"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/media?parent=6038"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/categories?post=6038"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/tags?post=6038"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}