Desipramine enhances opiate postoperative analgesia

Pain. 1986 Oct;27(1):45-49. doi: 10.1016/0304-3959(86)90220-4.

Abstract

In a double-blind, placebo-controlled study the analgesic efficacy of the combination of a tricyclic antidepressant and morphine was investigated. One of two tricyclic antidepressants (either amitriptyline, a relatively selective serotonin uptake inhibitor or desipramine, a relatively selective noradrenaline uptake inhibitor) or a placebo, was given for 1 week prior to surgery, followed by a single postoperative dose of morphine. Desipramine, but not amitriptyline, both increased and prolonged morphine analgesia. Neither tricyclic antidepressant reduced dental postoperative pain in the absence of morphine. We propose that desipramine enhances opiate analgesia by enhancing a noradrenergic component that contributes to endogenous opioid-mediated analgesia systems.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Amitriptyline / pharmacology*
  • Analgesia*
  • Desipramine / pharmacology*
  • Double-Blind Method
  • Drug Combinations
  • Drug Therapy, Combination
  • Humans
  • Morphine / pharmacology
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / psychology
  • Postoperative Period
  • Preanesthetic Medication*
  • Time Factors

Substances

  • Drug Combinations
  • Amitriptyline
  • Morphine
  • Desipramine