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Antidepressants for Cancer Pain


Tricyclic antidepressants

Generic Name Brand Name
desipramine Norpramin
doxepin Silenor
imipramine Tofranil
nortriptyline Aventyl, Pamelor

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Generic Name Brand Name
duloxetine Cymbalta
venlafaxine Effexor

Selective serotonin reuptake inhibitors (SSRIs)

Generic Name Brand Name
fluoxetine Prozac
paroxetine Paxil
sertraline Zoloft

How It Works

Antidepressant medicines increase levels of the chemicals produced in the brain to improve your mood. Lower doses relieve pain and may help you sleep.

Why It Is Used

In low doses, antidepressants may relieve chronic pain and pain related to the peripheral nervous system (neuropathic pain), such as cancer pain. They may also cause drowsiness, which may improve sleep and relieve fatigue.


How Well It Works

Some people find that low doses of antidepressants help relieve cancer pain. Researchers are still exploring whether and how well antidepressants affect cancer pain. These drugs can improve sleep. This, in turn, may improve your ability to manage your pain.

Side Effects

Different antidepressants have different side effects. If you have severe side effects from one drug, your doctor may give you a different one.

Most side effects decrease over time. They may include:

  • Constipation. Make sure you drink enough fluids while you are taking any of these drugs. Most adults should drink between 8 and 10 glasses of water or noncaffeinated beverages each day. Include fruits, vegetables, and fiber in your diet each day.
  • Diarrhea.
  • Dry mouth.
  • Nausea.
  • Changes in appetite or weight.
  • Nervousness or anxiety.
  • Blurred vision or glaucoma that gets worse.
  • Drowsiness or insomnia.
  • Low blood pressure.
  • Tremors and sweating.
  • Urinary retention.
  • Headache.
  • Decreased sex drive, impotence, or difficulty having an orgasm.



What To Think About


Studies have found that daily use of SSRIs may increase the risk of bone fracture in adults over age 50. Before taking an SSRI, talk to your doctor about this risk.

Amitriptyline is the most common antidepressant that is used to treat cancer pain. It may cause side effects, such as dry mouth, drowsiness, constipation, or difficulty urinating.


People with cancer pain and depression are often treated with one of the following:

  • Selective serotonin reuptake inhibitor (SSRI), such as sertraline (Zoloft), fluoxetine (Prozac), or paroxetine (Paxil)
  • Serotonin and norepinephrine reuptake inhibitor (SNRI), such as venlafaxine (Effexor) or duloxetine (Cymbalta)
  • Higher dosage of tricyclic antidepressant than is used for cancer pain alone





By Healthwise Staff
E. Gregory Thompson, MD - Internal Medicine
Michael Seth Rabin, MD - Medical Oncology
Last Revised September 11, 2013

