History

• Antidepressants work at the level of the brain.Image by Flickr.com, courtesy of Erik Ratcliffe
  
  Antidepressants work by affecting brain chemistry, which includes neurotransmitters. An important neurotransmitter that regulates mood and impacts our body's perception of pain is serotonin.
  
  

Significance

• Antidepressants may help to manage chronic back pain.Image by Flickr.com, courtesy of Mike Rolph
  
  Antidepressants take several weeks for the full effect to be realized. According to the National Institutes of Mental Health (NIMH), antidepressants take time to work, because the body needs to create new neurons or nerve cells. These new cells are integral to treating depression and chronic pain.
  
  

Types

• Migraine headaches can be debilitating.Image by Flickr.com, courtesy of Danny Williams
  
  The tricyclic antidepressants usually prescribed for chronic pain are Amitriptyline, Tofranil, Anafranil, Pamelor, Norpramin or Sinequan. Tricyclic antidepressant medications help to improve chronic pain from tension headaches, migraines, low back and nerve damage pain.
  
  

Types

• Neurotransmitters are released and taken up by neurons.Image by Flickr.com, courtesy of Mike Seyfang
  
  Selective serotonin reuptake inhibitors (SNRIs) such as Cymbalta and Effexor are also antidepressants, but seem to be less effective than the tricyclic antidepressants. Patients who do not obtain relief from the SSRI antidepressants may have success with a SNRI.
  
  

Effects

• Chronic pain causes the neurons in the brain to constantly fire signals of neurotransmitters that can negatively affect other neurons. Sometimes this process results in permanent brain damage.
  
  

Effects

• Depression may also result in brain damage, specifically a loss of neurons and brain atrophy. Neurogenesis or the creation of new neurons supports the efficacy of antidepressant drugs in treating chronic pain and depression.