Antidepressants are used for chronic pain because the pain puts stress on the body that “uses up” some beneficial brain neurotransmitters. This can both make us depressed and increase pain sensation, so these medications are used along with others to treat the overall pain experience.
Antidepressant Drugs
Selective serotonin reuptake inhibitors (SSRIs)
- Citalopram (Celexa)
- Escitalopram (Lexapro, Cipralex)
- Paroxetine (Paxil, Seroxat)
- Fluoxetine (Prozac)
- Fluvoxamine (Luvox)
- Sertraline (Zoloft, Lustral)
Selective norepinephrine reuptake inhibitors (NRIs)
- Atomoxetine (Strattera)
- Reboxetine (Edronax)
- Viloxazine (Vivalan)
Noradrenergic and specific serotonergic antidepressants (NaSSAs) inhibit reuptake of serotonin, and noradrenaline
- Mianserin (Tolvon)
- Mirtazapine (Remeron, Avanza, Zispin)
Serotonin–norepinephrine reuptake inhibitors (SNRIs) inhibit reuptake of serotonin and norepinephrine.
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Milnacipran (Ixel, Savella)
- Venlafaxine (Effexor)
Serotonin antagonist and reuptake inhibitors (SARIs) include:
- Etoperidone (Axiomin, Etonin)
- Nefazodone (Serzone, Nefadar)
- Trazodone (Desyrel)
Norepinephrine-dopamine reuptake inhibitors inhibit the neuronal reuptake of dopamine and norepinephrine
- Bupropion (Wellbutrin, Zyban)
Tricyclic antidepressants inhibit reuptake of norepinephrine and serotonin, although there are exceptions.
Tertiary amine tricyclic antidepressants:
- Amitriptyline (Elavil, Endep)
- Clomipramine (Anafranil)
- Doxepin (Adapin, Sinequan)
- Imipramine (Tofranil)
- Trimipramine (Surmontil)
Secondary amine tricyclic antidepressants
- Desipramine (Norpramin)
- Nortriptyline (Pamelor, Aventyl, Noritren)
- Protriptyline (Vivactil)
- amphetamine (Adderall) and dexamphetamine
- methylphenidate (Ritalin)
- modafinil (Provigil, Alertec)
- carbamazepine (Tegretol)
- sodium valproate (Epilim, Depakote)
- lamotrigine (Lamictal)
- clonazepam (Klonopin)
- oxcarbazepine (Trileptal)
- diazepam (Valium)
- clonazepam (Klonopin)
- lorazepam (Ativan)
- alprazolam (Xanax)
- temazepam (Restoril)
The most commonly prescribed antidepressants in the US retail market in 2010 were:
| Sertraline | Zoloft | SSRI | 33,409,838 |
| Citalopram | Celexa | SSRI | 27,993,635 |
| Fluoxetine | Prozac | SSRI | 24,473,994 |
| Escitalopram | Lexapro | SSRI | 23,000,456 |
| Trazodone | Desyrel | SARI | 18,786,495 |
| Duloxetine | Cymbalta | SNRI | 14,591,949 |
| Paroxetine | Paxil | SSRI | 12,979,366 |
| Amitriptyline | Elavil | TCA | 12,611,254 |
| Venlafaxine XR | Effexor XR | SNRI | 7,603,949 |
| Bupropion XL | Wellbutrin | NDRI | 7,317,814 |
| Mirtazapine | Remeron | TeCA | 6,308,288 |
| Venlafaxine ER | Effexor | SNRI | 5,526,132 |
| Bupropion SR | NDRI | 4,588,996 | |
| Desvenlafaxine | Pristiq | SNRI | 3,412,354 |
| Nortriptyline | Sensoval | TCA | 3,210,476 |
| Bupropion ER | NDRI | 3,132,327 | |
| Venlafaxine | Effexor | SNRI | 2,980,525 |
| Bupropion | Wellbutrin XL | NDRI | 753,516 |
EDS and Chronic Pain News & Info 
Sertraline affected me really badly I have suspected EDS, I got reflux symptoms and constant nausea and spewing I lost so much weight and about 2 years later I’m still struggling to put it back on I look ill, I got horrible night sweats and felt cold all the time with sweating and with random waves of hot flushes and I was exhausted, lost muscle tone because I was unable to exercise regularly, couldn’t sleep properly it was just horrible and I’m terrified to try another I can’t handle getting sicker.
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Yours are the worst side effects I’ve ever come across for any antidepressant. I’m curious how your doctor handled your reports of misery. Why didn’t they give you a different one right away?
It’s well-known that people may respond very, very differently to different versions of the same drug. I don’t see any reason you couldn’t have been switched to something that didn’t torture you so much.
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