The tricyclic antidepressants amitriptyline (Elavil, Endep) and nortriptyline (Aventyl, Pamelor) are options for people with chronic low back pain that does not respond to acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs). They may also be considered for people with nerve pain or pain that wakes them from sleep. They have a small to moderate effect on low back pain in a much lower dose than is needed to treat depression.
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