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Papers of the Week

2020 Jul 15

Rev Med Suisse



[Why using antidepressants in chronic pain ? Practical prescription recommendations].


El Biali M, Besson M
Rev Med Suisse. 2020 Jul 15; 16(700):1350-1353.
PMID: 32672012.


The use over the last 50 years of antidepressants having both serotonergic and noradrenergic properties, as the first line for the management of neuropathic pain or chronic pain syndromes, is based on a twofold rationale: on the one hand, a plausible analgesic mechanism of action independent of the effect on mood, on the other hand, efficacy data in humans and animals. Their prescription should be part of a multimodal approach to pain. The dose to reach the analgesic effect, which on average occurs within four weeks after the initiation of treatment, is sometimes lower than the dose required to achieve the antidepressant effect. The choice of antidepressant will rely on the profile of adverse effects and other expected secondary benefits in the case of comorbidities.