Drugs against depression and other mental conditions are also used to treat physical pain. Scientific evidence, however, do not yet allow a definitive conclusion. This entry was published a little later than expected. The day I should write on the connection between chronic and antidepressant pain, the hands and wrists hurt so much that I could not type for more than a few minutes. Ah, irony …
Fortunately, the pain has decreased a lot during a weekend. In the past, during typing or any activity that involved the use of the hands, it became almost impossible, I had to be absent from work for weeks.
The origin of this pain, however, is a mystery that none of the many doctors I have consulted over the years has been able to solve.
My case is common. Although we do not know the exact number of people who live in chronic pain all over the world, it is estimated that in the West about 20% of adults faces this problem, according to an estimate of the international association for the study of pain (IASP).
IASP defines chronic pain as “a condition in which an individual feels pain in most days or every day for more than three months”.
If pain significantly affects your daily life, for example when you can no longer cook, practice your favorite sport or write an article, it adapts to the classification of IASP as “chronic pain with a high impact”.
Chronic pain leads us to try almost everything
If you or someone you love you are part of this club, it is likely that you met at the point where I arrived about a year ago. I was willing to do almost everything that the pain disappeared.
I made several radiographs and magnetic resonances of impulses, arms, cervical and thoracic column, as well as a rheumatism test, all with positive result. I have tried various types of physical therapy, osteopathy and acupuncture, but none of these methods have helped a lot.
This is how, on a September morning 2024, I ended up sitting in front of a pain reliever, agreeing with emphasis with my head when I was asked: “Would you consider the experimentation of antidepressants?”
This is a question that, for many, does not fit well.
“Many patients feel insulted,” said Tamar Pincus, dean of the Faculty of Environmental Sciences and Life at the University of Southampton, in the United Kingdom, in an interview with DW. “They think that the doctor is suggesting that the pain would be only in their minds.”
“Why are the antidepressants if I’m not depressed?”
Pincus said that over time, ordinary pain relievers tend to stop working. This made her and other researchers in the area to look for alternative solutions.
There are several logical reasons for considering antidepressants as an alternative to conventional pain relievers. One is that chronic pain can influence a person’s mood or mental health.
“A great percentage of people who live with chronic pain, about 40%, is in a bad mood,” said Pincus. “They are not clinically depressed, but they feel guilty of not working at work or home, and often they cannot do what they want or love to do.”
Antidepressants, Pincus said, can help in this and also help with the pain itself. The chemicals that antidepressants regulate in the brain, such as serotonin and norepinephrine, influence both mood and pain.
“The areas involving the processing of pain in our brain are close to those that elaborate negative emotions,” said Pincus.
Therefore, it makes sense to think that the same drugs used to treat depression can also alleviate chronic pain. But the search for Pincus and colleagues does not seem to support this idea.
Clinical studies are not conclusive
In collaboration, the global revision of Cochrane health data, researchers from the University of Southampton analyzed the results of 176 clinical studies on antidepressants and chronic pain. The tests involved around 30,000 patients and 27 different antidepressants.
The analysis of the results was worrying: the tests on the effect of antidepressants on chronic pain seemed insignificant and produced so scarce data among the essays that were confident about the effectiveness of one of the 27 antidepressants tested, duloxetine.
Another medicine, Amitriptiline, has not passed the test, although it is precisely the most commonly prescribed antidepressant for chronic pain in the United States, the United Kingdom and in Germany – and it is one of the two drugs that have been taking for almost a year.
None of the amitriptiline tests analyzed by the experts involved sufficient participants to be considered reliable.
This does not mean that amitriptiline is totally ineffective against chronic pain. During the interview, I told Pincus that my symptoms started to improve drastically after taking amitriptiline for about four weeks and also slept much better. It was not at all surprised to hear it.
“We work with groups based on groups,” said the expert. “We cannot predict how an individual reacts to medicine. Amitriptiline, a type of medicine called tricyclic antidepressant, can have fairly unpleasant side effects, as caused sleepy.”
For me, as an individual, Amitriptiline worked well – maybe I was lucky. But in the group’s analysis, the researchers found a low overall efficacy and a high probability of side effects for the drug. This is not good when trying to evaluate whether a medicine can offer a good treatment for a greater number of people.
The best advice: “Live life to the fullest”
Even the Duloxetine, which actually seemed to reduce the pain and increase people’s ability to return to daily activities, showed only short -term effectiveness. And there were few data on any side effect or damage that the drug can actually cause long -term.
“The results were promising, but [a falta de informações sobre possÃveis danos] I worry, “said Pincus.
While we finish the conversation, the expert, who has his experience with chronic pain, gave me advice on what could be the most natural alternative to drugs.
“Live life as much as possible,” he said. “Be adventurous with your creativity. When you do it, the synapses in your brain change. Any type of activity that brings you joy helps you to live with chronic pain.”
Source: Terra
Rose James is a Gossipify movie and series reviewer known for her in-depth analysis and unique perspective on the latest releases. With a background in film studies, she provides engaging and informative reviews, and keeps readers up to date with industry trends and emerging talents.
