Antidepressants: Another weapon against chronic pain

Some of the more effective and commonly used medications for chronic pain are drugs that were developed to control other conditions. Antidepressants are a mainstay in the treatment of many chronic pain conditions — even when depression isn't a factor.

Tricyclic antidepressants

Amitriptyline is the antidepressant most commonly prescribed for pain, and it's the one that has been studied most thoroughly. Other tricyclic antidepressants used for pain include:

• Imipramine (Tofranil)
• Nortriptyline (Pamelor)
• Desipramine (Norpramin)

Tricyclic antidepressants seem to work best for the burning or searing pain common after nerve damage, which sometimes occurs with diabetes, shingles or strokes. These drugs are also effective in some people for fibromyalgia, or as a preventative for migraines.

The painkilling mechanism of these drugs is still not fully understood. Tricyclic antidepressants may increase neurotransmitters in the spinal cord that reduce pain signals. But they don't work immediately. You may have to take a tricyclic antidepressant for several weeks before it starts reducing your pain.