Many patients with depression report having symptoms of pain, even though in many cases, this cannot be explained. However, two classes of antidepressants have been shown to be effective in reducing these symptoms.
Jan Jaracz, MD, PhD, Poznan University of medical Sciences, Poznan, Poland, and colleagues examined 50 patients who participated in a depression study that were diagnosed with moderate or severe depressive episode. The participants were randomized to receive either escitalopram or nortriptyline.
More than 80% of participants in both groups complained of pain at the outset of the trial. However, after two weeks of treatment, patients in both groups said their pain intensity had decreased significantly, the researchers reported in the journal General Hospital Psychiatry.
In addition, improvements in pain also preceded improvement in depression severity. Patients reported a 50% reduction in pain intensity before saying their depression severity was reduced by 50%.
“Both selective serotonergic and noradrenergic antidepressants are equally effective in alleviations of painful physical symptoms of depression,” the researchers concluded.
Unexplained painful physical symptoms are commonly reported by depressed patients. The evidence suggests that dual-action antidepressants are potent in relieving pain in depression. However, a direct comparison of the effects of selective serotonergic and selective noradrenergic antidepressants on painful symptoms has not been investigated so far.
Sixty patients who participated in the Genome-based Drugs for Depression (GENDEP) study, with a diagnosis of moderate or severe episodes of depression according to ICD-10 and DSM-IV, criteria were involved.