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What Are Opioids?

Opioids are narcotic pain medications that contain natural, synthetic or semi-synthetic opiates. Opioids are often used for acute pain, such as short-term pain after surgery. Some examples of opioids include:

Opioids are effective for severe pain and do not cause bleeding in the stomach or other parts of the body, as can some other types of pain melievers. However, they can be extremely addictive and doctors will try to find alternatives to prescribing them. It is rare for people to become addicted to opioids if the drugs are used to treat pain for a short period of time. But if used to treat chronic pain, the risk of addiction is real and potentially dangerous.

Side effects of opioids may include:

  • Drowsiness
  • Nausea
  • Constipation
  • Itching
  • Breathing problems
  • Addiction

What Are Antidepressants?

Antidepressants are drugs that can treat pain and/or emotional conditions by adjusting levels of neurotransmitters (natural chemicals) in the brain. These medications can increase the availability of the body’s signals for well-being and relaxation, enabling pain control for some people with chronic pain conditions that do not completely respond to usual treatments. Research suggests certain antidepressants (tricyclics) work best for neuropathic or nerve pain.

Chronic pain conditions treated by low-dose antidepressants include some types of headaches (like migraines) and menstrual pain. Some antidepressant medications include:

  • Selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
  • Tricyclic antidepressants such as amitriptyline, desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), and nortriptyline (Pamelor)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta) and venlafaxine (Effexor)

These drugs require a steady dose of the medicine buildup in the body over a period of time to work. The doses needed to treat pain are often lower than those needed to treat depression.

Generally, SSRIs and SNRIs have fewer side effects than tricyclic antidepressants. The most common side effects with antidepressants include:

  • Blurry vision
  • Constipation
  • Difficulty urinating
  • Dry mouth
  • Fatigue
  • Nausea
  • Headache

What Are Anticonvulsants?

Anticonvulsants are drugs typically used to treat seizure disorders. Some of these medications are shown to be effective in treating pain as well. The exact way in which these medicines control pain is unclear but it is thought that they minimize the effects of nerves that cause pain. Some examples include carbamazepine (Tegretol), gabapentin (Neurontin), pregabalin (Lyrica), and toperamate (topamax).

In general, anticonvulsants are well tolerated. The most common side effects include:

  • Drowsiness
  • Dizziness
  • Fatigue
  • Nausea

Other Pain Treatments

Another means of topical pain relief comes in the form of a lidocaine (Lidoderm) patch, which is a prescription medication.

If your pain is not relieved by the usual treatments, your doctor may refer you to a pain management specialist. Doctors who specialize in pain management may try other treatments such as certain types of physical therapy or other kinds of medicine. They may also recommend TENS, a procedure that uses patches placed on the skin to send signals that may help stop pain.

Spinal cord stimulation (SCS) involves implanting a small device somewhat like a pacemaker in the epidural space adjacent to the area of the spine which is believed to be the source of the pain. It sends mild electric pulses through leads to help mask and interrupt the pain signals to your brain.

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