“Which antidepressant is best for chronic pain?”

Good Morning. Several antidepressants have shown benefits for chronic pain management. One of the oldest and with a good track record of relative safety is Amitriptyline (Elavil). Typically taken once a night at bedtime, in small doses like 10 mg, it can be effective and safe for many. Consult your primary care doctor to be certain that you have no risks in using it. Others may work as well, but Amitriptyline has been around for a long time and seems to help many people, especially with nerve-related (neuropathic type) pain. Good luck!

Duloxetine.

Nortryptyline and duloxetine both are effective.

Many, but best ones are tricyclic and SSRI such as duloxetine.

I am an acupuncturist and treat lots of neck and spine pain. Most patients prefer it to a pill. I would find out correct diagnosis before doing anything.

Cymbalta, generic is Duloxetine.

The answer to this question would also depend on your medical history and other medical problems. Without knowing this information the most common anti-depressant used for chronic pain and nerve pain is Cymbalta. Not every patient can be on Cymbalta and it also depends on what your other medications are as well.

There are a couple prominent antidepressants that are also indicated for Pain Conditions. Cymbalta or Duloxetine indicated for Fibromyalgia, Diabetic Neuropathic Pain, and Chronic Musculoskeletal Pain. In my experience with patients, this seems to provide the best benefit for most people, although we are all uniquely made. Savella or Milnacipran is indicated for Fibromyalgia and works as a Serotonin and Norepinephrine reuptake inhibitor, a typical mechanism of several antidepressants. Tricyclic Antidepressants such as Amitriptyline and Nortriptyline are an older class of depressants that are often used as adjuncts to treat pain, but often have side effects prominent in the elderly, particularly sedation, confusion, and dry mouth are often seen in my experience. The Tricyclic Antidepressants do have a place, but their action for helping control or treat depression is far less efficacious than the more modern Antidepressants. I would recommend a discussion with your prescribing doctor and if you have a psychiatrist and a pain physician keep them both fully aware of what the other is prescribing. It is important for both doctors to be aware of each other and of all medications prescribed.