Patient Information: Chronic Pelvic Pain
TCA's (Tricyclic antidepressants) are used in high doses (75-300 mg daily) to treat depression, and in low doses (10-50 mg daily) to treat chronic pain and sleep problems. They have been proven to work in patients with back pain, headache and chronic pelvic pain.
How does it work for pain?
How does it work for depression?
All of us go through ups and downs. As you would expect, people with chronic pain have more downs than ups. Many experts think that part of the problem is due to low levels of a chemical in the brain called "serotonin". Low serotonin levels are found in people with depression, sleep problems and chronic pain. These symptoms can often be improved by higher dose TCA's which can return serotonin levels to normal. It is important that any thoughts of suicide be discussed with a professional, especially if they become more frequent. If you feel you need to be on a higher dose of your TCA because of continuing symptoms of depression, please call your provider.
Dose: The three TCA's used most often are: Imipramine (Tofranil) Doxepin (Sinequan) Amitriptyline (Elavil)
The usual starting dose is 10-25 mg at bedtime. It can take from one to four weeks for the drug to start working. Always consult with your provider staff members before changing your dose.
Peer Review Status: Internally
Last modification date:
Thu Aug 23 12:28:58 2007