Abstract
Antidepressants are important analgesic adjuncts in the treatment of chronic non-cancer pain. This chapter is based on systematic reviews of high-quality randomized clinical trials of antidepressant agents in multiple chronic non-cancer pain conditions. Three classes of antidepressant agents have been widely tested for efficacy in chronic pain: Tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors and selective serotonin reuptake inhibitors (SSRIs). Serotonin-norepinephrine reuptake inhibitors, developed shortly after SSRIs, proved more efficacious in treatment of chronic pain. This pharmacologic class includes the medications duloxetine, venlafaxine, desvenlafaxine and milnacipran. Systematic reviews and meta-analyses support the use of TCAs for headache disorders and various neuropathic pain conditions, but not for chronic low back pain. Evidence is equivocal for TCA use in fibromyalgia.
| Original language | English |
|---|---|
| Title of host publication | Clinical Pain Management |
| Subtitle of host publication | A Practical Guide, Second Edition |
| Publisher | wiley |
| Pages | 173-180 |
| Number of pages | 8 |
| ISBN (Electronic) | 9781119701170 |
| ISBN (Print) | 9781119701156 |
| DOIs | |
| State | Published - Jan 1 2022 |