Treatment strategies that address both depressive symptoms and chronic pain are ideal.17 These treatment modalities include psychotherapeutic techniques such as cognitive-behavioral therapy, medications, and somatic treatments such as ECT.18 In Mrs. P’s case, ECT was an effective treatment that caused remission of psychotic depressive symptoms, which lead to improved pain control and restored social and occupational functioning.
Related Resources
- Schreiber S, Shmueli D, Grunhaus L, et al. The influence of electroconvulsive therapy on pain threshold and pain tolerance in major depression patients before, during and after treatment. Eur J Pain. 2003;7(5):419-424.
- Suzuki K, Ebina Y, Shindo T, et al. Repeated electroconvulsive therapy courses improved chronic regional pain with depression caused by failed back syndrome. Med Sci Monit. 2009;15(4):CS77-CS79.
- Giesecke T, Gracely RH, Williams DA, et al. The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort. Arthritis Rheum. 2005;52(5):1577-1584.
Drug Brand Names
- Amitriptyline • Elavil
- Benztropine • Cogentin
- Carbamazepine • Tegretol
- Citalopram • Celexa
- Clonazepam • Klonopin
- Clozapine • Clozaril
- Escitalopram • Lexapro
- Gabapentin • Neurontin
- Lithium • Eskalith, Lithobid
- Olanzapine • Zyprexa
- Oxycodone/ acetaminophen • Vicodin
- Phenytoin • Dilantin
- Thiothixene • Navane
- Trazodone • Desyrel, Oleptro
- Ziprasidone • Geodon
Disclosures
Dr. Kugler reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
Dr. Magid receives NARSAD grant support.