Role of Antidepressants in Chronic Pain Management
Antidepressants may be indicated for several reasons; one is that many patients with chronic pain disorders become clinically depressed and a medication intervention may be necessary depending upon an assessment of their problem. The Addiction-Free Pain Management® approach always suggests that a full biopsychosocial evaluation be taken to determine the severity of the depression.
Some types of depression (situational) respond best to cognitive behavioral therapy. Other types (bipolar) may need a medical intervention in addition to therapy. There are many different types or classifications of antidepressants to choose from, therefore a healthcare practitioner who specializes in treating depressive disorders related to chronic pain should be consulted to determine the most effective medication for each patient.
Pain reduction is another key factor that may benefit from using an antidepressant. The use of tricyclic antidepressants has been an effective tool in pain management for years. For example, the tricyclic Elavil (amitriptyline) is frequently used to treat and help prevent migraine headaches. These antidepressants have been able to provide relief for nerve pain and often result in lowering the dose of opiate medications.
Another class of newer antidepressants is the SSRIs (selective serotonin reuptake inhibitors). Many pain management specialists utilize this type of medication for chronic pain treatment particularly for people who live with constant debilitating chronic pain, as their serotonin system becomes depleted. This type of medication is good for both depression as well as improving pain management.
SSRIs like Prozac, Effexor, Lexapro, or Celexa, improve mood as well as help relieve pain, reduce fatigue and improve sleep problems. There have been reports about SSRIs being helpful for some types of neuropathic pain symptoms. Some studies also suggest that using an SSRI and a tricyclic antidepressant (such as amitriptyline) together may be more successful at breaking the cycle of pain, depression, and sleep problems caused by fibromyalgia than using just either one alone.
In addition, there are three antidepressant medications that can also be very helpful; Cymbalta and Effexor, which block the reuptake of serotonin and norepenepherine and Wellbutrin, which alters the levels of norepenepherine and dopamine. Cymbalta is a versatile medication approved to treat depression and certain types of pain. Norepenepherine, serotonin, and dopamine are neurotransmitters that not only affect depression but also pain management. Many pain management specialists recognize that combining different medications creates a synergistic effect for both pain management and improving depression.
If you want to read more about depression and chronic pain management you can find my article The Role of Clinical Depression in Chronic Pain Management that you can download for free on our Ariticles page.
If you want to learn more about the Addiction-Free Pain Management® System please check out our website at www.addiction-free.com. To learn more about how to develop an effective chronic pain management plan please go to our Publications page and check out my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To look for my upcoming trainings please go to our Calendar page.
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