Title:Depression and Pain: Use of Antidepressants
Volume: 20
Issue: 2
Author(s): Herlinda Bonilla-Jaime*, José Armando Sánchez-Salcedo, M. Maetzi Estevez-Cabrera, Tania Molina-Jiménez, José Luis Cortes-Altamirano and Alfonso Alfaro-Rodríguez
Affiliation:
- Departamento de Biología de la Reproducción, Universidad Autónoma Metropolitana-Iztapalapa, Apartado Postal 55
535, C.P. 09340, Ciudad de México, México
Keywords:
Depression, pain, antidepressants, chronic pain, neuropathic pain, chronic disease.
Abstract:
Background: Emotional disorders are common comorbid affectations that exacerbate the
severity and persistence of chronic pain. Specifically, depressive symptoms can lead to an excessive
duration and intensity of pain. Clinical and preclinical studies have been focused on the underlying
mechanisms of chronic pain and depression comorbidity and the use of antidepressants to reduce
pain.
Aim: This review provides an overview of the comorbid relationship of chronic pain and
depression, the clinical and pre-clinical studies performed on the neurobiological aspects of pain
and depression, and the use of antidepressants as analgesics.
Methods: A systematic search of literature databases was conducted according to pre-defined
criteria. The authors independently conducted a focused analysis of the full-text articles.
Results: Studies suggest that pain and depression are highly intertwined and may co-exacerbate
physical and psychological symptoms. One important biochemical basis for pain and depression
focuses on the serotonergic and norepinephrine system, which have been shown to play an important
role in this comorbidity. Brain structures that codify pain are also involved in mood. It is evident
that using serotonergic and norepinephrine antidepressants are strategies commonly employed to
mitigate pain
Conclusion: Literature indicates that pain and depression impact each other and play a prominent
role in the development and maintenance of other chronic symptoms. Antidepressants continue to
be a major therapeutic tool for managing chronic pain. Tricyclic antidepressants (TCAs) are more
effective in reducing pain than Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-
Noradrenaline Reuptake Inhibitors (SNRIs).