$Unique_ID{BRK02399}
$Pretitle{}
$Title{Are Antidepressants Good For Headaches?}
$Subject{prescription headaches antidepressant medication tricyclic
heterocyclic noncyclic maoi monoamine oxidase inhibiting medications
depression antidepressants chronic pain serotonin analgesia ill defined
symptoms symptom medicine medicines prescriptions tension headache analgesic
nonpsychiatric}
$Volume{N-1,R-1}
$Log{
Tension Headaches*0003904.scf}

Copyright (c) 1992,1993   Tribune Media Services, Inc.


Are Antidepressants Good For Headaches?


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QUESTION:  I am just a bit disturbed about a prescription that my own doctor
gave to me.  I suffer from headaches, several each week, and they are
difficult to control with ordinary pain medicine.  I know my doctor has been
most patient with me, but the last prescription he gave me was described by
the pharmacist as an "antidepressant".  Does that mean my doctor has given up
on me and thinks that I am nuts?  Have you ever heard of any situation like it
that would help you counsel me?

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ANSWER:  Questions such as yours about the use of antidepressants for pain
control are not infrequent, and so it would seem that many doctors other than
just your own are turning to these medications for a number of situations in
which pain is an important factor.  And that is not astonishing in view of the
many articles that are now appearing in the research literature.
     Antidepressants come in many forms, with names that indicate a bit about
their chemical structure; tricyclic, heterocyclic, noncyclic and MAOI (for
monoamine oxidase inhibiting).  Though the first effective formula was
discovered in 1958, the Food and Drug Administration has approved all these
related medications as useful only for depression.  However, when a doctor
finds the pain of his patient continuing despite the best efforts of both
patient and physician, the growing literature offers some documentation for
the nonpsychiatric use of antidepressants in helping to control chronic pain.
Among some of these situations are the pain that accompanies nerve damage due
to diabetes, pain that remains after an attack of shingles, chronic tension
headache, and fibrositis.  Although the exact mechanism of pain suppression is
unclear it is thought to be due to the ability of tricyclic antidepressants to
increase serotonin activity.  It has been shown in animals that increased
serotonin is associated with reduction of pain analgesia.  The use of
antidepressants to combat pain is a complex problem where patient and drug
selection, doses and careful monitoring of the effects in the patient must all
be conducted in a careful and continuing manner.  When it works, the relief of
the chronic pain makes all the difficulties with the therapy very worthwhile
to both patient and doctor.  What is clear, however, is that your doctor is
not giving up, but merely trying to obtain relief for you.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.