Use of antidepressants in chronic pain

Peter M Herriot



Many antidepressants have analgesic effects independent of their antidepressant effects and can be effective analgesics even in patients without concurrent depression. They should be prescribed in a systematic manner and with care to avoid drug interactions.

Key Points

  • Antidepressant medications have an important role in the treatment of chronic pain.
  • The analgesic effects of antidepressant medications are independent of their antidepressant effect; they can therefore be prescribed for chronic pain syndromes even in the absence of comorbid depression.
  • Tricyclic antidepressants and serotonin and noradrenaline reuptake inhibitors are generally the antidepressants of choice when treating patients with chronic pain.
  • It is important that both prescribers and patients are clear about the indication for prescribing and the symptoms being targeted.

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