Osteoarthritis and Antidepressants

Antidepressants may also be prescribed for chronic pain caused by osteoarthritis.

Cymbalta, or duloxetine, is the most commonly prescribed antidepressant for osteoarthritis.

Read more details about Antidepressants.

Trazodone

The most common side effects associated with trazodone use include: nausea, dizziness, muscle pain, loss of coordination, tiredness, dry mouth, constipaton, headache and blurred vision. Call your doctor immediately if you have any new or worsening symptoms such as: unsual changes in behavior, anxiety, panic attacks, trouble sleeping, or if you

feel impulsive, irritable, agitated, hostile, aggressive, restless, more depressed, or have thoughts about suicide or hurting yourself.

Drug interactions

Patients taking trazadone are advised to avoid alcohol. It is also important to inform your doctor about all the prescription and over-the-counter drugs that you are taking. The following drugs may

interact with trazadone:

•indinavir (Crixivan) or ritonavir (Norvir);

•ketoconazole (Nizoral) or itraconazole (Sporanox);

•digoxin (Lanoxin, Lanoxicaps);

•carbamazepine (Carbatrol, Tegretol) or phenytoin (Dilantin);

•warfarin (Coumadin);

•MAO inhibitors, such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

Mirtazapine

Remeron may cause weight gain, sometimes this may requiring discontinuation of treatment. Mirtazapine may increase cholesterol and triglyceride levels. Other

common side effects include: dizziness, nausea, flu symptoms and constipation. Seek immediate medical attention when you experience any severe side effect such as Severe allergic reactions, mental or mood changes thoughts of hurting yourself, tremors and worsening of depression.

Drug interactions

Mirtazapine potentiates the sedating effects of other drugs of drugs that can cause sedation such as the benzodiazepine class of anti-anxiety drugs, the narcotic pain relievers, tricyclic class of antidepressants, certain drugs for hypertension and some antihistamines. Mirtazapine should not be used with MAO inhibitors such as selegilin (Carbex), phenelzine (Nardil), furazolidone (Furoxone), procarbazine (Matulane), or tranylcypromine (Parnate). Avoid drinking alcohol because it may worsen some of the

side effects of mirtzapine.

Arthritis Foundation website. Available at: http://www.arthritis.org/ .

Conn’s Current Therapy . 54th ed. WB Saunders Company; 2002.

Drug Facts and Comparisons . 56th ed. Facts & Comparisons; 2001.

Health Library editorial staff and contributors. Medications for fibromyalgia. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated August 6, 2010. Accessed August 27, 2010.

Hydrocodone and acetaminophen. EBSCO Health Library, Lexi-PALS website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated March 19, 2010. Accessed August 27, 2010.

Lexi-PALS. Duloxetine. EBSCO Health Library, Lexi-PALS website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated March 19, 2010. Accessed November 15, 2010.

Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. American Family Physician . 2000;51(6). Available at: http://www.aafp.org/afp/20000315/1795.html.

Mayo Clinic. Osteoarthritis: treatments and drugs. Mayo Clinic website. Available at: http://www.mayocli... . Updated July 8, 2010. Accessed August 27, 2010.

National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .

Propoxyphene. EBSCO Health Library, Lexi-PALS website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated March 22, 2010. Accessed August 27, 2010.

3/17/2007 http://www.ebscohost.com/dynamed/what.php : Yelland MJ, Nickles CJ, McNairn N, Del Mar CB, Schluter PJ, Brown RM. Celecoxib compared with sustained-release paracetamol for osteoarthritis: a series of n-of-1 trials. Rheumatology (Oxford). 2007;46:135-140. Epub 2006 Jun.

2/7/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Underwood M, Ashby D, Cross P, et al. Advice to use topical or oral ibuprofen for chronic knee pain in older people: randomised controlled trial and patient preference study. BMJ. 2008;336:138-142. Epub 2007 Dec 4.

10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

11/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: US Food and Drug

Administration. FDA clears Cymbalta to treat chronic musculoskeletal pain. US Food and Drug Administration website. Available at: http://www.fda.gov.... Published November 4, 2010. Accessed November 12, 2010.