What are Antidepressants?
Antidepressants are the medicines which are used to treat Depression and Depression is something which doesn't really need an introduction, as this affliction is found in many people and is becoming more and more common day by day. Medically speaking, depression is an illness that involves the mind, mood, thoughts and body. Depression affects the way a person eats and sleeps, the way a person feels about oneself, and the way a person thinks about things. Antidepressants are drugs used to treat depression.
What are Analgesics?
Analgesics are medicines used for relieving pain, both acute pain as well as chronic pain.
The Relationship Between Depression & Pain
Depression and pain are correlated. Pain is depressing, and depression causes and intensifies pain, forming a vicious cycle. Depression can be caused due to long-term or chronic pain. A chronic pain is defined as pain that lasts longer than 6 months. The signals of chronic pain may remain in a person's nervous system for a long time, and starts affecting a person's psychological and physical health. Chronic pain may be originated due to various reasons like a history of trauma or injury. Other reasons include infection or some other ongoing causes.
How Does Pain Affect or Cause Depression? What Should Be The Treatment Plan?
Emotional status of the patient markedly affects the severity of the pain. An effective treatment should include treating both depression and pain at the same time.
Invention of Antidepressant Analgesics
The drugs that are useful for both depression and pain were originally invented to cover just depression; however, over a period of time, it was apparent that these medicines were also helpful in relieving certain types of pains. Though the list is not very long, but there are drugs that give excellent results with both the problems, i.e. depression and pain. Such types of medicines are termed as "Antidepressant Analgesics."
How Do Antidepressant Analgesics Benefit Chronic Pain?
Chronic pain management has always been a challenge for clinical practice. There have been evidences that show that antidepressants like Tricyclic Antidepressants (TCAs) and Serotonin Noradrenalin Reuptake Inhibitors (SNRIs) have been very effective in the treatment of various types of musculoskeletal pain like low back pain, neuropathic pains, chronic pain syndrome, and fibromyalgia. Here, we will take a look at some of these drugs or Antidepressant Analgesics, which have dual benefits i.e. they work as antidepressants and as an analgesic.
Antidepressants and Nerve Pain
Certain types of antidepressants also help to control nerve pain. They may have a synergistic effect in people who experience depression along with chronic pain.
3 Commonly Used Antidepressant Analgesics
There are antidepressants that address both depression and pain and they include the following:
Antidepressant Analgesic #1: Tricyclic Antidepressants (TCAs).
- Amitriptyline is a drug of choice in the above-mentioned category, i.e. Antidepressant Analgesic and it is also the most thoroughly studied agent. It belongs to the class Tricyclic Antidepressants (TCA). This medication is used to treat mental/mood problems, such as depression and also helps in improving mood and feelings of well-being, relieves anxiety and tension, helps you sleep better, and increases your energy level. On the other hand, this drug also helps with chronic pain in temporomandibular joint disease (TMJ), neuropathic pain, and migraine, e.g. Elavil and Endep for nerve pain.
- Imipramine is another Tricyclic antidepressant which is primarily an antidepressant, but has very good effect on chronic pain thus bringing this under the category of Antidepressant Analgesic. Some of the brand names of imipramine include Tofranil which helps with chronic pain, neuropathic pain and rheumatoid arthritis pain.
- Nortriptyline is another drug of choice which is an Antidepressant Analgesic and relieves chronic pain, e.g. Pamelor benefits migraine.
Antidepressant Analgesic #2: Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
- Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant and an Antidepressant Analgesic used for treating depression, anxiety disorder and pain. Data has shown these medications to have efficacy for the treatment of not only depression, but also of painful peripheral neuropathies. It provides a great deal of pain relief in people suffering from fibromyalgia and chronic pain syndrome. Duloxetine carries a U.S. Food and Drug Administration indication for the treatment of depression ad pain. Some of the examples of this Antidepressant Analgesic includes Cymbalta, which is also prescribed for neuropathic pain.
- Venlafaxine is a new selective SNRIs and an Antidepressant Analgesic, which helps relieve fibromyalgia pain, whether the patient is depressed or not. Example includes Effexor for fibromyalgia.
Antidepressant Analgesic #3: Selective Serotonin Reuptake Inhibitors (SSRIs)
Citalopram is a drug belonging to the class of SSRI and is an Antidepressant Analgesic. A study has tested the effects of citalopram and how it can be used to treat depression and pain in fibromyalgia patients, e.g. Celexa for treating fibromyalgia.
What are the Side Effects of Antidepressant Analgesics?
- Tricyclic antidepressants are the Antidepressant Analgesics, which can cause side effects like dizziness, constipation, blurred vision and upset stomach. They might not be safe for people with certain conditions like heart problems.
- SNRI drugs have fewer side effects than Tricyclic Antidepressants. They might be safer for some, especially older people with heart problems. However, they might not be as effective as tricyclics in tackling nerve pain.
What are the Benefits of Antidepressants Analgesics?
Some of the types of pain relieved by Antidepressants Analgesics are:
- Antidepressants Analgesics benefits pain caused by arthritis.
- It can help alleviate nerve pain and damage from diabetes (diabetic neuropathy).
- Antidepressants Analgesics are beneficial in treating nerve pain and damage from shingles (post-herpetic neuralgia).
- Antidepressants Analgesics also benefit Nerve pain from other causes, such as peripheral neuropathy, spinal cord injury, stroke and radiculopathy.
- It helps relieve tension headache and migraine.
- Antidepressants Analgesics are beneficial in alleviating facial pain.
- Antidepressants Analgesics greatly benefit the pain of Fibromyalgia.
- Antidepressants Analgesics are helpful for low back pain.
- Antidepressants Analgesics alleviate pelvic pain.
Antidepressants Analgesics: CONCLUSION
Hence we can safely conclude that Antidepressants Analgesics are the preferred drug in patients who are suffering from both depression and any of the above-mentioned types of pain. The complexity of chronic pain requires an extensive knowledge of the potential actions of many pharmacological agents. The physician should always think about the innovative application of medications regardless of their traditional classification and use.