Neurological Associates

Pain Management Center

Vero Beach, Florida

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RSD PUZZLE #83
Antidepressants and Pain


Narcotics are essential in treatment of pain (not the morphine agonists causing withdrawal pain, but the agonists. (see below for more on this)

Elavil has been around for over a quarter of century . It has been most exhaustively studied. It is an excellent analgesic. If you cold turkey Elavil your pain will recur with a vengeance. However in the first year of taking Elavil an average patient gains 18 pounds of weight. It also causes fatigue, low blood pressure and is stressful to the heart muscle. *

Another tricyclic, Desipramine, is an excellent antidepressant and analgesic without the above mentioned side effects of Elavil.

Even though antidepressants prevent pain, they do not replace the proper use of narcotic analgesics. The two are complimentary.

Trazodone is as effective as Desipramine or Elavil in pain control. It should be started in a small dose and gradually increased and adjusted upward or downward to achieve 8 hours of uninterrupted sleep, without the side effects of drowsiness the next day.

The SSRI's: Prozac , Paxil and Zoloft are excellent antidepressants. However one out of five patients loses their sex desire with SSRI's. This loss is bad for anybody's health. Zoloft is the least analgesic. Prozac is the most likely to cause agitation.

* The use of Elavil should be avoided- It should be replaced with Desipramin, Trazodone, etc... according to the patient's tolerance.


H.Hooshmand, M.D.

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Copyright © 1997-2006 H. Hooshmand, M.D. No part of this publication may be reproduced, transmitted, stored in a retrieval system other than this specific media, transcribed, or translated into any language without the expressed written permission from the author; H. Hooshmand, M.D. and Eric Phillips and CMNE. This material is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician.

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The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2006 H. Hooshmand, M.D.

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This page was last updated on 3/11/2000.