Depression and Pain: Use of Antidepressants

Background: Emotional disorders are common comorbid affectations that exacerbate theseverity and persistence of chronic pain. Specifically, depressive symptoms can lead to an excessiveduration and intensity of pain. Clinical and preclinical studies have been focused on the underlyingmechanisms of chronic pain and depression comorbidity and the use of antidepressants to reducepain. Aim: This review provides an overview of the comorbid relationship of chronic pain anddepression, the clinical and pre-clinical studies performed on the neurobiological aspects of painand depression, and the use of antidepressants as analgesics. Methods: A systematic search of literature databases was conducted according to pre-definedcriteria. 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-exacerbatephysical and psychological symptoms. One important biochemical basis for pain and depressionfocuses on the serotonergic and norepinephrine system, which have been shown to play an importantrole in this comorbidity. Brain structures that codify pain are also involved in mood. It is evidentthat using serotonergic and norepinephrine antidepressants are strategies commonly employed tomitigate pain Conclusion: Literature indicates that pain and depression impact each other and play a prominentrole in the development and maintenance of other chronic symptoms. Antidepressants continue tobe a major therapeutic tool for managing chronic pain. Tricyclic antidepressants (TCAs) are moreeffective in reducing pain than Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs).