Pain Management Strategies: Some Uses of Antidepressant Medications and Non- Pharmacological Approaches
Pp. 171-183 (13)
Kathy Sexton-Radek, Antoine Chami and Alissa Rubinfeld
It is estimated that some 25-30% of the population in the United States have
experienced chronic pain. Worldwide, estimates reflect values of 35-40%. Chronic pain
prevalence figures intensify the treatment approaches to care. Both pharmacological
and non-pharmacological care is provided to address pain discomfort—oftentimes, at
an individualized level. Relatively new strategies of prescribing additional pain
management prescriptions of anti-depressant medications have enhanced the quality of
care of the chronic pain patient. Sensory inputs from ascending pathways to the brain
are targeted by pain medications. The common pathway to the cerebrum, at the
periaqueductal gray which is largely noradrenergic and serotonergic, provides an
additional platform to provide pharmacological treatment to the chronic pain patient.
Anti-depressant medications act in many regions of the brain including the
periaqueductal area. The resultant modulation of pain serves to also enhance the
perception of pain relief from other pain medications. The adjuvant pain management
treatment of anti-depressant medications is presented in terms of the types of chronic
pain treated, the proposed mechanism of action of the antidepressant medications, and
the other medications used in conjunction with anti-depressant medications.
Pain Medications, Pain, Antidepressant Medication, Cognitive
Behavior Therapy, Medication Management, Pharmacological Treatment, Pain
Disorders, Pain Questionnaires, Cognitive Therapy, Complex Pain.
Suburban Pulmonary & Sleep Associates/Elmhurst College, North Riverside, IL, USA.