Antidepressant drugs are often used for the treatment of pain in patients who are not depressed. Randomized controlled trials (19 indicate that antidepressants, in doses within the usual therapeutic range, provide more effective analgesia than placebo preparations in the treatment of diabetic neuropathy, postherpetic neuralgia, and atypical facial pain, as well as chronic non-malignant pain. Antidepressants are more effective than acetylsalicylic acid and benzodiazepines. Different tricyclic antidepressants appear to be equally effective and are more effective than selective serotonin reuptake inhibitors. The analgesic effect occurs in patients who are not depressed and is independent of any antidepressant effect.
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