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Internal Medicine

Answer 2
  1. Selective serotonin reuptake inhibitors are less effective than are tricyclic antidepressant agents in the treatment of postherpetic neuralgia. Tricyclic antidepressant agents are more effective for the treatment of postherpetic neuralgia (and other neuropathic pain) than are selective serotonin reuptake inhibitors.2 Pain character is not predictive of drug effectiveness. Although commonly used, antidepressant agents are not approved by the US Food and Drug Administration (FDA) for the treatment of postherpetic neuralgia. Antidepressant agents can safely be used in elderly patients and are typically effective at a significantly lower dose for postherpetic neuralgia than that which is needed for the treatment of depression.

     McQuay HJ. Tramer M, Nye BA, et al. A systematic review of antidepressants in neuropathic pain. Pain 1996;68:217-27.

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