The obvious use for antidepressants is for depression but now tricyclic antidepressants are used widely for back and chronic pain.
They have been proven to treat some cases of chronic pain. After my first visit to a pain clinic, I was put on a low dose of tricyclic antidepressants to treat my pain. At first, I was a little apprehensive about being labelled ‘depressed’ but then when I looked into the drugs I was being prescribed I understood the difference in them being used for pain rather than depression. The main difference was the strength of the drugs as for pain you are only given a low dosage but for depression, you are given a much larger dose.
Amitriptyline and Nortriptyline are one of the most widely used tricyclic antidepressants used for the treatment of chronic pain which I take at night. They explained to me that it works as a muscle relaxant for my pain and although I was prescribed 10mg I was told I could more than double the amount if I needed it. If the medication is ineffective, your dose can be gradually increased. This approach will help to lower the risk of side effects.
It also says to avoid drinking alcohol while you are taking either of them as the combined effects can make you feel very drowsy. This is important to remember as I found you really do feel very drowsy and drunk if you have had a drink before you take them.
The NHS state that ‘Antidepressant medication can also help to relieve pain for some people with fibromyalgia. They boost the levels of certain chemicals that carry messages to and from the brain, known as neurotransmitters.
Low levels of neurotransmitters may be a factor in fibromyalgia, and it’s believed that increasing their levels may ease the widespread pain associated with the condition.
There are different types of antidepressants. The choice of medicine largely depends on the severity of your symptoms and any side effects the medicine may cause.
Antidepressants used to treat fibromyalgia include:
- tricyclic antidepressants – such as amitriptyline
- serotonin-noradrenaline reuptake inhibitors (SNRIs) – such as duloxetine and venlafaxine
- selective serotonin reuptake inhibitors (SSRIs) – such as fluoxetine and paroxetine
A medication called pramipexole, which isn’t an antidepressant, but also affects the levels of neurotransmitters, is sometimes used as well.
Antidepressants can cause a number of side effects, including:
- feeling sick
- dry mouth
- feeling agitated, shaky or anxious
- weight gain