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Tricyclic antidepressants can be used for in the management of a range of chronic pain syndromes, including: - neuropathic pain:
- post-herpetic neuralgia
- diabetic neuropathy
- post-stroke pain
- irritable bowel syndrome
- temporomandibular joint dysfunction
- atypical facial pain
- fibromyalgia
- migraine
In many of these conditions 50-90% of patients can be expected to achieve a 50% or greater reduction in pain. The number of patients needed to be treated in order to achieve a 50% reduction in pain in an individual patient are: - 3.0 in diabetic neuropathy
- 2.8 in atypical facial pain
- 1.7 in post-stroke pain
The trial evidence is generally for low dose amitriptyline (25-100 mg/day). Other antidepressants may be effective.
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