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September 15, 1978

Psychotropic agents finding analgesic use

JAMA. 1978;240(12):1225. doi:10.1001/jama.1978.03290120019003

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Reports are increasing regarding the efficacy of antipsychotic and antidepressant drugs in raising pain thresholds when used alone or as adjuncts to analgesics.

The "target" effects of psychotropic medications on symptoms of psychosis and depression have been described often and extensively. But more recently there also has been news of such agents' usefulness in managing acute and chronic pain syndromes.

In the November 1977 issue of Headache, Heikki Hakkarainen, MD, of the Tampere, Finland, University Hospital reported results of a double-blind crossover study with 50 patients suffering chronic tension headaches. (The trial was completed by 48 patients; two stopped treatment because of extrapyramidal side effects.) The study compared placebo and fluphenazine, a fluorinated piperazine derivative of phenothiazine, with each patient receiving two 0.5-mg tablets daily for two months.

According to Dr Hakkarainen, there was a statistically significant reduction in the duration and severity of pain with fluphenazine vs that obtained