Doctors don’t know exactly why antidepressants help with pain. They may affect chemicals in your spinal cord -- you may hear them called neurotransmitters -- that send pain signals to your brain.
It's important to note that antidepressants don’t work on pain right away. It can be a week or so before you feel any better. In fact, you may not get their full effect for several weeks. If your pain isn’t better after that, your doctor might change your dose or suggest that you try a different medicine.
What Can They Help Treat?
They may help ease symptoms caused by:
- Diabetic neuropathy (nerve damage caused by diabetes)
- Spinal cord injury
- Tension or migraine headaches
- Lower-back or pelvis area problems
Which Ones Might Help With Pain?
Tricyclics have been around since the 1950s and are the most common antidepressants prescribed for pain. They affect two chemicals in your body -- serotonin and norepinephrine. Both help regulate your mood.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) also affect those two chemicals, but they work in different ways than tricyclics. There are many versions of these, but the only one approved by the FDA to treat pain is duloxetine (Cymbalta).
Bupropion affects norepinephrine and another chemical called dopamine, which regulates many parts of our behavior.
Selective serotonin reuptake inhibitors (SSRIs) only affect serotonin. Studies have shown that they don’t seem to work on pain as well as other kinds of antidepressants.
What Are the Possible Side Effects?
Tricyclics can cause:
- Dry mouth
- Blurred vision
- Weight loss
- Weight gain
- Issues with your sex life
If you take duloxetine, you might have:
At first, SSRIs also can make you:
They may also give you:
They also can affect your sex life.
Bupropion can lead to:
It also may make you feel:
In some people, it can also cause: