Savvy Psychopharmacology

When to prescribe antidepressants to treat comorbid depression and pain disorders

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References

Using pain medication to treat depression

Conversely, the use of pain medications to treat depression also has been studied. The most notable data supports the use of ketamine, an anesthetic. IV ketamine is well documented for treating pain and, in recent years, has been evaluated for MDD in several small studies. Results show that IV ketamine, 0.5 mg/kg, produced a rapid response in depressed patients.16 For pain conditions studies support the use of ketamine as an IV push, continuous infusion, intermittent infusion, as well as oral administration, for many conditions, including acute and postoperative pain, chronic regional pain, and neuropathic pain. However, there is little evidence evaluating ketamine’s effect on both pain scores and depression symptoms in patients such as Ms. C.

Related Resources

  • Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia.
  • Cochrane Database Syst Rev. 2014;(1):CD007115. doi:10.1002/14651858.CD007115.pub3.
  • McCleane G. Antidepressants as analgesics. CNS Drugs. 2008;22(2):139-156.

Drug Brand Names
Amitriptyline • Elavil
Atenolol • Tenormin
Duloxetine • Cymbalta
Desipramine • Norpramin
Fluoxetine • Prozac
Gabapentin • Neurontin
Imipramine • Tofranil
Levomilnacipran • Fetzima
Losartan • Cozaar
Ketamine • Ketalar
Milnacipran • Savella
Naproxen • Aleve, Naprosyn
Nortriptyline • Pamelor
Sertraline • Zoloft
Venlafaxine XR • Effexor XR

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