This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
To the Editor.—
The recent BRIEF REPORT by Davis and associates prompts me to share my observations about the use of tricyclic antidepressants and phenothiazines for the management of pain syndromes.In my work as a consulting psychiatrist to three university-affiliated pain clinics located in two different geographic settings, I have noted the frequent use by neurosurgeons and anesthesiologists of amitriptyline and fluphenazine as well as amitriptyline and chlorprothixene for the management of chronic pain. The drugs are prescribed in low doses, and analgesic results are usually evident within three to four days, thus being consistent with the results reported by Davis and associates. Although I wonder about the operation of the placebo factor, I now find myself using these drugs for certain pain syndromes and noting some success.Although these drugs are not addicting and tolerance does not occur, they are not without hazard. The tricyclics, especially amitriptyline, have
Weddington WW. Treatment of Peripheral Diabetic Neuropathy. JAMA. 1978;239(11):1037. doi:10.1001/jama.1978.03280380037011
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: