This content has not been reviewed within the past year and may not represent Web MD's most up-to-date information. To find the most current information, please enter your topic of interest into our search box. " July 19, 2005 -- Antidepressants should be used as an initial treatment for the frequently disabling pain caused by nerve tissue damage, according to a new review of research on the issue. Researchers reviewed 50 studies of 19 different antidepressants in the treatment of pain caused by nerve tissue damage, also known as neuropathic pain. They found that the older class of antidepressants called tricyclics can provide significant pain relief. These include medications such as amitriptyline, imipramine, clomipramine, desipramine, and nortriptyline. Anticonvulsant drugs were also shown to alleviate neuropathic pain. Healthcare professionals should closely evaluate patients with cognitive decline for possible underlying treatable conditions. While most dementias are progressive with no cure, approximately 20% are reversible. 32 Dementia describes a group of symptoms resulting in a gradual and progressive decline in memory, thinking, and reasoning abilities. Medication-induced dementia is the most common cause of reversible dementia. Elders are especially vulnerable due to concomitant illnesses, reduced renal and liver function, and the simultaneous use of multiple medications.1 Other common reversible causes include depression, infection, high fever, vitamin deficiencies, poor nutrition, hypercalcemia, brain tumors, thyroid disorders, and hypoxia due to lung and heart diseases. Alzheimer’s disease (AD) is the most common type of irreversible dementia. Other irreversible types include vascular or multi-infarct dementia, dementia with Lewy bodies (DLB), frontotemporal dementias (Pick’s disease), and Parkinson’s dementia (PD).
Pain and depression are closely linked in the brain, and medications used in depression can be helpful in the controlling pain. Some antidepressants directly impact pain, while others only affect depression. Antidepressants are most helpful in treating pain caused by damage to nerves or by an overactive nervous system (aka neuropathic pain). Specifically, antidepressant medications can help treat the following painful conditions: Antidepressants such as Zoloft, Prozac, Celexa, and Effexor have no affect on pain. These medications decrease nerve transmission and nerve sensitivity. The TCAs have many side affects including dry mouth, low blood pressure, sedation, and urinary problems. Cymbalta is very effective in a number of neuropathic pain situations including diabetes, radiculopathy, and fibromyalgia, while Savella only is known to work in fibromyalgia. The nerve fibers that transmit pain sensation travel through the brain in the same regions that process emotional signals. Stimulating depression centers can increase the perception of pain. Do you worry about the effects of long-term use of antidepressants? These drugs are among the most commonly prescribed in the United States, and they're often prescribed for long-term use. But is it safe to use antidepressants for years on end? In spite of how popular these drugs are, we're just learning what those long-term effects may be. Extended studies are rarely done before a drug gains approval, so medications can be around for a long time before we start to get a clear picture of what can happen after years of continuous use. In your brain, information—including emotion—moves from one neuron (brain cell) to another via chemical messengers called neurotransmitters. Each one unlocks certain receptors (chemical "locks") on neurons in order to allow the message to keep traveling. In the diseases and conditions listed above, as well as many others, something is messed up with the neurotransmitters—usually serotonin and/or norepinephrine, and possibly dopamine and/or a few others. In some cases, the brain may not use it efficiently, or the problem could lie with the receptors.
Neuropathy, and chronic back pain. In lower doses, the side effects of TCAs are not that bad and they tend to disappear over time when patients continue to take. Most of the studies involved SSRIs such as citalopram Celexa or sertraline Zoloft. Patients with dementia and diabetic neuropathy who exhibit undesirable.