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How do tricyclic antidepressants treat low back pain?

Donna Hill Howes, RN
Family Practitioner

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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