The effectiveness of tricyclic antidepressants in the treatment of coexisting pain and depression

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Abstract
A group of moderately to severely depressed individuals with moderate anxiety were studied to determine the frequency and nature of pain complaints and their response to doxepin. Of these subjects 100% had chronic pain complaints, most of which paralleled the course of depression. Headache was most commonly noted. Doxepin''s analgesic effects were intimately associated with its antidepressant effects. There was a highly significant relationship between improvement of depression and reduction of pain on doxepin (P < 0.005). Patients who obtained minimal antidepressant effect also obtained minimal analgesic effect. Psychophysiologic and biochemical hypotheses of this association of pain and depression are discussed.

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