An antidepressant for migraines? This is how it can work in pain management

Your doctor may prescribe an antidepressant for a person with chronic pain, not because the patient is depressed. Admittedly, there is no harm in improving your mood, as it also helps you to tolerate pain better.

Some doctors would prefer an antidepressant to treat chronic pain rather than an NSAID or a triangular medicine that acts on the central nervous system.

An antidepressant should be tried for pain in almost everyone other than those prone to mania.

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Pros compared to painkillers:

  • Although antidepressants have their drawbacks, they do not endanger the intestinal mucosa, so you need to use stomach-blocking acid blockers with them.
  • Painkillers and antidepressants can often be used at the same time.
  • Antidepressants do not cause physical dependence as strong painkillers can do. Therefore, it is also easier to disassemble the medication than a triple medication that causes physical and mental dependence.

The effectiveness of antidepressants in the treatment of pain is based on the same as in the treatment of depression. They prevent the removal of the pain-reducing noradrenaline mediator from nerve cells.

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Newer drugs work in the same way, but with more pain mediators at the same time. The latest antidepressants, duloxetine and venlafaxine, are also stimulants, making them best taken in the morning.

The oldest antidepressants, such as amitriptyline, which is most commonly used to treat pain, may make you tired. Admittedly, it can be good, especially for older people, if an antidepressant gives you sleep.

Can be used for even a decade

Often an antidepressant for dry mouth or fatigue. It is also not taken temporarily but is used continuously. Once a suitable product is found, it can be used for decades. This is the case, for example, in the treatment of fibromyalgia.

When treating nerve pain, antiepileptics, pregabalin or gabapentin, which also reduce anxiety, may also be combined with antidepressants.

If the patient is annoyed that the prescription includes an antidepressant, it is advisable for the doctor to add pain management as an indication.

For these antidepressants are effective:

  • tension headache
  • migraine
  • osteoarthritis pain
  • rheumatic pain
  • fibromyalgiaan
  • back pain
  • shingles
  • nerve pain
  • cancer pain

Read more about pain treatment Current care recommendations.

The expert is psychiatrist Ulla Lepola.

This article appeared in Good Health. As a subscriber, you can read all numbers free of charge from the service.

Source: Hyvä Terveys by

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