Table 6.
Antidepressants Commonly Used to Treat Pain
| Antidepressant | Analgesia | Reuptake inhibition | Adverse effects | Elimination of half-life of parent drug (hr) | ||||
|---|---|---|---|---|---|---|---|---|
| NE | SE | Anticholinergic effects | Postural hypotension | Sedation | Cardiac arrhythmia | |||
| Nortriptyline | +++ | ++ | ++ | ++ | + | + | +++ | 18-48 |
| Amitriptyline | +++ | ++ | ++ | +++ | +++ | +++ | +++ | 9-46 |
| Imipramine | +++ | ++ | ++ | +++ | +++ | ++ | +++ | 6-28 |
| Desipramine | ++ | +++ | 0 | + | ++ | + | +++ | 12-28 |
| Paroxetine | + | 0 | +++ | 0 | 0 | 0 | 0 | 21 |
| Citalopram | + | 0 | +++ | 0 | 0 | 0 | 0 | 24 |
| Venlafaxine | ? | ++ | +++ | 0 | 0 | 0 | 0 | 4 |
NE: norepinephrine, SE: serotonin.
Modified from Max and Gilron (Antidepressants, muscle relaxants, and N-methyl-D-aspartate receptor antagonists. In: Bonica’s Management of Pain. 3rd ed. Edited by Loeser JD; 2000, pp. 1710-26) [59].