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These medicines have been around a long time. In the last twenty years a new generation of anti-depressants have been developed which are much safer and have less unwanted effects. Like the some of the other medicines above, anti-depressants need to get into the brain to work, and can cause similar unpleasant effects. Again these effects can be reduced by starting slowly at first, or by tailing off slowly and not stopping the medicine quickly.
Antidepressants can improve pain by increasing some of the chemicals in our brain and spinal cord. This can have the effect of turning down the loudness on pain (a bit like a volume control on a stereo)
Often people with pain will say ‘I’m not depressed - I’m in pain’. We do know from lots of good research studies that some of the control over pain that our brains have is not as good if we are depressed or anxious. It’s like the volume control we mentioned gets stuck. If our mood can improve (with medicines, relaxation, or other types of non-drug treatment) we can get the volume control turned back down again.