Treatment of chronic pain with tricyclic antidepressants

Tricyclic antidepressants are increasingly being used to treat chronic pain. A review of the literature supports their use in a variety of conditions and sheds some light on the question as to whether they exert a direct analgesic effect or act indirectly, by first alleviating an intercurrent depression. Their use is recommended for chronic pain before resorting to narcotics or neurosurgery.