PAIN THERAPY WITH ANTIDEPRESSANTS

Antidepressants have no direct analgesic properties. Because of their 5-HT-agonistic effects some substances of this group such as amitripty line stimulate the antinociceptive system and thus antidepressants can be helpful in the pharmacologic therapy of chronic pain syndromes. Th e classic indication for pain relief with antidepressants is pain due to major depression but in chronic pain syndromes of somatic origin th e pain relieving effect of antidepressants is thought to be independen t of their antidepressive effect. Monotherapy as well as combination w ith analgesics and therefore a reduction of the daily dose of analgesi cs can be achieved. Neuropathic pain, deafferentiation pain, central p ain and chronic tension-type headache are appropriate indications for a pain therapy with antidepressants.