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    Antidepressants: 1st Choice for Nerve Pain

    Study Says Older Antidepressants Should Be Used to Treat Certain Types of Pain

    Older Antidepressants Still Work for Nerve Pain continued...

    The study showed that tricyclic antidepressants, particularly Amitril, were most effective in easing neuropathic pain caused by diabetes and shingles.

    Although these results are promising, researchers say antidepressants do not cure or eliminate all pain.

    "The amount of pain reduction is moderate at best. Typically the pain reduction averages around 40% in 50% of treated patients," says researcher Dennis C. Turk, PhD, of the University of Washington, in a news release. "This means that a significant proportion of patients do not obtain even moderate reductions in pain, and even those who do continue to experience significant pain."

    Researchers say more studies are needed to evaluate the effects of newer antidepressants as well as alternative medicines, such as St. John's wort, before they can be recommended for treating neuropathic pain.

    Anticonvulsants May Also Help Nerve Pain

    Researchers say the results of their review of anticonvulsants in treating neuropathic pain are both encouraging and conflicting.

    Anticonvulsants were originally developed to treat epilepsy in the 1960s and have increasingly been used to treat pain. The drugs are thought to work by quieting abnormal firings of the nerves in the brain and central nervous system.

    In their review, researchers analyzed 23 trials of anticonvulsant drugs involving more than 1,000 people.

    They say the results of these studies are conflicting and suggest that each anticonvulsant drug needed to be evaluated independently to determine its effectiveness in treating neuropathic pain in comparison with other anticonvulsants and antidepressants.

    For example, 15 studies of Neurontin showed that its effectiveness was comparable to another anticonvulsant, Tegretol, in relieving neuropathic pain. Neurontin has fewer side effects, but researchers say it is more expensive than other alternatives and cheaper treatments are also effective.

    Therefore, researchers say anticonvulsants should be reserved as a second choice for treating pain caused by nerve tissue damage after first trying treatment with antidepressants.

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