Some chronic pain patients are surprised when they are prescribed antidepressant medication for their pain.

“I've been in pain all my body for six months, doctors prescribe painkillers, but they don't help much...”

This is a common complaint. Then something else is added, “I told the doctor about my pain. He gave me an antidepressant.” “What is this now? Was it prescribed by mistake? Did the doctor find me depressed because of my pain? Am I depressed? Is that why I have pain? Or is the pain in my head? Am I making it up?” Follow-up questions like these arise.

The answer to this is: It's possible, you may be depressed. Depression is an expected condition in individuals with chronic pain, i.e., those who have had pain for more than 3 months. However, this doesn't mean your pain is psychological. In other words, you're not experiencing pain because your psychology is disturbed. On the contrary, your psychology is disturbed because your pain has lasted for a long time. Even if your depression is treated, your pain will persist.

So, why were you given an antidepressant?

The antidepressant medication given to you has pain-relieving properties.” “Oh, antidepressant medications also relieve pain?” No, not all antidepressants. Only three specific antidepressants (antidepressants containing venlafaxine, amitriptyline, and duloxetine) have some pain-relieving properties in certain types of pain. However, this property is not applicable to all types of pain. In other words, taking an antidepressant when you have a headache is not the right approach. It won't work. These specific antidepressants are effective in certain types of pain and often enhance the effects of other pain relievers when used together.

Now, let's give an example. Aspirin. What does aspirin do? As everyone knows, aspirin reduces fever, relieves pain, and thins the blood. These three effects are different from each other. But aspirin affects all of them. Similarly, these antidepressants both prevent depression and have pain-relieving effects. Therefore, they can be effective in separate conditions. However, as I mentioned earlier, not every antidepressant has this property. Only three specific drugs have this effect.

Therefore, to benefit from the pain-relieving property, you need to use the antidepressant recommended by your doctor.

In this way, these drugs, whose primary purpose is not pain relief but have some pain-relieving effects in specific cases, are referred to as adjunct analgesics.

Another point is, if you are also depressed along with your pain, the medication used for its pain-relieving property may not be effective for your depression at the recommended doses. For this, you need to consult a psychiatrist."