Archive For The “Antidepressants” Category

Antidepressants and Pain Control: Doxepin

By | May 8, 2012

Doxepin is a tricyclic antidepressant with significant anxiolytic properties. Its side effect profile is significantly better than the other commonly used tricyclic compounds, but its efficacy in treating severe cases of neuropathic pain also appears to be less. At Schlesinger Pain Centers it is used mainly for mild to moderate chronic pain in sensitive individuals […]

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Antidepressants and Pain Control: Nortriptyline

By | May 7, 2012

Nortriptyline is a second-generation tricyclic antidepressant.  Although not specifically approved by the FDA for the treatment of neuropathic pain, several randomized controlled trials have demonstrated its effectiveness in treating neuropathic pain in both depressed and no-depressed individuals and the International Association for the Study of Pain recommends nortriptyline as a first-medication for that use.  Its […]

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Antidepressants and Pain Control: Amitriptyline

By | May 4, 2012

Amitriptyline (Elavil) is one of the oldest tricyclic antidepressants and while rarely used for depression it still finds significant use in the treatment of chronic pain. Its side effect profile tends to limit its use in the elderly and the infirm, but its unrivalled potency makes it invaluable in cases of severe pain complicated by […]

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SNRIs and You: Milnacipran

By | February 5, 2012

With milnacipran we come full circle in our examination of the pain medicine nee antidepressant. Milnacipran was developed in France as an antidepressant and approved for the use in 1996 and is used for that purpose in over 45 countries worldwide. Milnacipran marketed in the United States as Savella was approved by the FDA in […]

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SNRIs and You: Duloxetine

By | February 4, 2012

Duloxetine, marketed in the US as Cymbalta by Eli Lilly, is an antidepressant of the serotonin norepinephrine reuptake inhibitor (SNRI) class, which has received FDA approval for a number of chronic pain syndromes. While moderately effective in the treatment of major depression I rarely use it for this purpose at Schlesinger Pain Centers. Duloxetine like […]

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SNRIs and You: Venlafaxine

By | February 3, 2012

The first drug that Melissa will discuss in her featured topic presentation prior to next Monday’s Schlesinger Pain Centers Support Group meeting is venlafaxine. It is very commonly prescribed by Dr. Schlesinger as well as other practitioners, due to its cost advantage when compared to other drugs in its class. Venlafaxine is the first serotonin […]

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SNRIs and You

By | February 2, 2012

Melissa has told me that the Featured Topic to be discussed at the beginning of next Monday’s Schlesinger Pain Centers Support Group will be “SNRIs and You”. She chose that topic because so many of our patients are taking Serotonin Norepinephrine Reuptake Inhibitors. Melissa will discuss some of the more common medications, indications and side […]

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Mild Back Pain: The Problem with Antidepressants

By | August 25, 2011

  We next talked about the possibility of starting her on antidepressants for her chronic back pain. Susan stated that her brother was a psychiatrist and that she didn’t want to take any medicine that he would be likely to prescribe. I said that I would not be overly concerned with the stigma attached to […]

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On Personal Identity: Drugs and Learned Behavior

By | August 19, 2011

I would like to explore the question of causation with respect to drug therapy, behavior and personal identity.  I believe that the best model for this is the use of SSRI’s and SNRI’s in the treatment of both depression and impulsive and aggressive behavior. Most physicians agree that there are no immediate effects and that […]

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Antidepressants and Pain Control: A Historical Perspective, SNRI’s

By | August 16, 2011

Serotonin norepinephrine reuptake inhibitors, SNRI’s are similar to the selective serotonin reuptake inhibitors, SSRI’s in that both inhibit the reuptake of neuroactive amines at the synaptic junction, but the SNRI’s have a broader spectrum. In low doses they function primarily by inhibiting the reuptake of serotonin, while at moderate doses they block the reuptake of […]

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