As the name suggests, antidepressant medications are used to manage symptoms of depression and, in some cases, other mental illnesses like anxiety and PTSD. But did you know that antidepressants are also commonly prescribed for people without depression or any other mental illness, for that matter?
That’s right! Antidepressants are often used for persistent and chronic pain management, especially neuropathic pain. Antidepressants may also help with chronic migraines, arthritis pain, and low back and neck pain. But the big question remains, how do antidepressants help relieve neuropathic pain?
What is Neuropathic Pain?
Neuropathic pain is caused by malfunction of or damage to the nervous system. This may result from injury, surgery, infection, or various other conditions. When the nervous system is damaged, it doesn’t send signals correctly to the brain, which results in ongoing pain.
Neuropathic pain often manifests as a burning, tingling, or shooting sensation and can be extremely debilitating, making it difficult to sleep, work, or enjoy life’s simple pleasures.
The Science Behind Chronic Pain
Central sensitization is one of the main factors underlying the development of chronic pain. Central sensitization is when the nervous system becomes overly sensitive to stimuli, and as a result, pain signals become amplified. When this happens, the nervous system is less able to filter out pain signals, which may result in a chronic pain state.
How Do Antidepressants Help with Neuropathic Pain?
The mechanism by which antidepressants help with neuropathic pain is not entirely clear. However, experts believe antidepressants work by modulating chemical messengers that facilitate neurotransmission in the brain, such as serotonin, dopamine, and norepinephrine.
By modulating these neurotransmitter systems, antidepressants can help restore healthy nerve communication between various parts of the brain and reduce the overreaction of the nervous system to pain signals. This culminates in reduced pain sensitivity.
There are a variety of antidepressants that may be prescribed for neuropathic pain, such as tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).
In most cases, the starting dosage of antidepressants for neuropathic pain is lower than the initial dosage used to treat depression. However, the dosage may be increased gradually over time to achieve the desired effect.
How Effective Are Antidepressants for Neuropathic Pain?
Studies have shown that antidepressants can provide moderate to substantial relief from neuropathic pain. One report revealed that at least 1 in 3 people who took traditional antidepressants for neuropathic pain reported experiencing moderate pain relief or better.
While this may not sound significant, it is worth noting that neuropathic pain is notoriously difficult to treat, and any form of relief is welcome for those suffering from this debilitating condition.
It’s important to remember that antidepressants can take time to work, and it may be several weeks before the full effect of the medication kicks in. If there are no changes whatsoever, your doctor may up your dosage or prescribe a different antidepressant.
The Bottom Line
Neuropathic pain is a very complex chronic pain condition, and there is no one-size-fits-all solution. While some people may benefit from traditional painkillers, others may find more relief from alternative medications such as antidepressants.
If you have been diagnosed with neuropathic pain and haven’t found relief with other treatments, it may be worth talking to your doctor about the possibility of trying an antidepressant treatment course. While there is no guarantee that antidepressants will work for you, some people will find adequate pain relief from using antidepressants.