Pain, pain, go away: antidepressants and pain management.

This ongoing column is dedicated to the challenging clinical interface between psychiatry and primary care-two fields that are inexorably linked.Pain, including neuropathic pain, is a relatively common complaint in various clinical settings. Several antidepressants have been efficacious in the management of chronic neuropathic pain, including the tricyclic antidepressants (particularly the tertiary-amine subtypes, such as amitriptyline, doxepin, and imipramine) as well as venlafaxine, bupropion, and duloxetine. The selective serotonin reuptake inhibitors have either been less robust (paroxetine, citalopram) or lacked any efficacy at all (fluoxetine). In this article, we review these various medications and offer an interpretive comparison, as there are few head-to-head comparison studies.