It is not yet fully understood why certain tricyclic antidepressants like Elavil relieve pain, but there are several theories. In fact, even the exact antidepressant mechanism of these drugs are not well understood either.
Elavil, also known as Endep or Vanatrip and by its generic name Amitriptyline, is most commonly prescribed for the relief of symptoms of depression. However, pain management specialists have found it to be effective in helping to control chronic pain of the neuralgic form.
This pain relieving capacity of anti-depressants were at first believed to be linked to the depression mitigation effects, as depression may often be tied in with chronic pain. However, some anti-depressants, Elavil among them, have been seen to reduce pain even in patients not experiencing depression.
These agents are now thought of as having an inherent analgesic action. The action is in all probability linked to the effects of the antidepressants on monoamine neurotransmitters present in biological pain pathways. Tricylic antidepressants are thought to work by inhibiting the re-uptake of the monoamine neurotransmitters norepinephrine, dopamine, or serotonin by nerve cells.
The effectiveness of serotonin and norepinephrine selective anti-depressants (SSRIs) indicates that effects on nerve pathways involving either of these transmitters may contribute to a pain-relieving effect.
Other theories suggested entail antihistamine properties of Elavil, the increased density of cortical calcium pathways and the spinal cord, or raised levels of endorphins.
Elavil is the most common antidepressant to be prescribed for pain, as well as the one that has been studied most. Other tricyclic antidepressants employed for pain management include:
- Imipramine (Tofranil)
- Desipramine (Norpramin)
- Nortriptyline (Pamelor)
Elavil seems to work most effectively for burning or searing forms of pain, such as diabetic neuropathy, postherpetic neuralgia or strokes. These drugs are also effective in some for fibromyalgia, and for migraine avoidance.
These drugs can make you drowsy, may cause constipation, dry mouth, difficulty with urination, weight gain, or changes in blood pressure. Discuss the use of Elavil for pain relief with your doctor.