The efficacy of newer antidepressants in the treatment of chronic pain: a review of current literature.

Tricyclic antidepressants have been extensively studied and frequently used in the treatment of various chronic pain syndromes. Newer antidepressants, namely fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, trazodone, nefazodone, bupropion, mirtazapine, and venlafaxine, have also been considered for this indication, although they have been less extensively studied. This article reviews the available publications, including placebo-controlled trials, other outcome studies, and case reports, pertaining to the use of these medications for chronic pain. Although some of these newer compounds may be effective for specific types of pain, making generalizations regarding their use as analgesics is difficult, given the limitations of existing data. Additional observations based on the data are presented in the hope that they may help to guide further research and clinical use.