Antidepressants and anti-seizure medications

Some medications commonly prescribed to manage depression and prevent seizures have been found to help relieve chronic pain. This is true especially for chronic nerve pain. They may help relieve back pain, fibromyalgia and diabetes-related nerve pain, known as diabetic neuropathy. Because chronic pain often worsens depression, antidepressants may offer the extra benefit of treating mood symptoms.

• Generic (brand) names. Tricyclic antidepressants used in the treatment of chronic pain include amitriptyline and nortriptyline (Pamelor).

  Serotonin and norepinephrine reuptake inhibitors, known as SNRIs, that may be prescribed to relieve chronic pain include duloxetine (Cymbalta, Drizalma Sprinkle), venlafaxine (Effexor XR) and milnacipran (Savella).

  Anti-seizure medications used to treat chronic nerve pain include gabapentin (Gralise, Neurontin, Horizant) and pregabalin (Lyrica). These medications treat the burning pain of shingles, known as postherpetic neuralgia. And they treat pain related to nerve damage in the legs and feet due to diabetes, known as diabetic neuropathy.

• How they work. Anti-seizure medications quiet pain signals from nerve cells. They may be helpful for stabbing or shooting pain from nerve damage. These medications may take several weeks before you notice the effects.
• Benefits and risks. Side effects of these medications are generally mild but may include nausea, dizziness or drowsiness. As a group, antidepressants and anti-seizure medications may, rarely, worsen depression or cause suicidal thoughts. If you notice changes in your thinking patterns or mood while taking these medications, talk with your healthcare professional right away.
• Bottom line. To reduce the risk of side effects, your healthcare professional may start you on a small amount of these medications and gradually increase the dose. When it's time to stop taking them, work with your healthcare professional to gradually lower the dose before stopping the medication completelyYour healthcare professional likely will recommend that you take these medications before bedtime.