Are antidepressants also pain relievers?

Did you know that antidepressant medications are often prescribed for people without depression? It’s true. Antidepressants are frequently prescribed for chronic pain, especially pain related to nerve disease (called neuropathic pain), chronic low back or neck pain, and certain types of arthritis. In fact, some guidelines for the treatment of chronic low back pain and osteoarthritis (the most common type of arthritis) include antidepressants. One antidepressant in particular, duloxetine (Cymbalta), is FDA-approved for these conditions. Just how antidepressants reduce pain is not well understood. One possibility is they affect chemicals in the brain involved in pain perception, a mechanism that differs from how they fight depression. Not usually the first choice for pain relief For people with chronic low back or neck pain or osteoarthritis of the hip or knee, an antidepressant medication is not usually the first treatment recommended. Other approaches, such as physical therapy, exercise, losing excess weight, nonsteroidal anti-inflammatory drugs (NSAIDs), or cortisone injections are usually tried first. But if these aren’t helpful, antidepressants such as duloxetine or amitriptyline might be a reasonable next step. When prescribed for pain, the initial dose is typically low (often lower than the starting dose for depression). It’s gradually increased if necessary. Ideally, people notice a benefit within weeks of starting the drug, and the medication can be continued at ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Bones and joints Health Osteoarthritis Pain Management Source Type: blogs