Antidepressant drugs have been used successfully in the treatment of
chronic pain syndromes. Clinical trials have supported the use of these drugs for
pain and the depression that often accompanies
pain syndromes. Although the exact mechanisms of action have not been clearly elucidated, it has been suggested that these agents have
analgesic properties independent of their
antidepressant effect on mood and behavior.
Pain patients without concomitant depression experienced
pain relief with
antidepressant therapy; these patients represent the most convincing evidence that
antidepressant drugs have a direct
analgesic effect. Studies presented in this paper support the clinical efficacy of
antidepressant medications in the treatment of patients suffering from
headaches (migraine, tension, and mixed types),
diabetic neuropathy,
arthritis, and
facial pain. These data also suggest that
antidepressant drugs may be effective in the treatment of
postherpetic neuralgia,
back pain, and
pain from mixed etiologies; however, data for these
pain syndromes are less clear, and, thus, further testing is required.