Effectiveness of Tricyclic Antidepressants (TCAS) in Management of Chronic Orofacial Pain
Orofacial pain (OFP) diagnosis and management are challenging because of their complex histories, pathophysiology and are usually associated with psychosocial co-morbidities such as depression, stress and anxiety. TCAs are selective serotonin reuptake inhibitors resulting in increased activity of descending inhibitory pain pathways. Thus, the aim of this study is to assess the effectiveness of low dose amitriptyline in management of OFP. This prospective study included 50 OFP patients who visited the university dental hospital from February 2018 to December 2019. These patients were treated with 10mg of amitriptyline and their VAS score was measured at baseline, 15 days, 30 days, and 45 days. The most prevalent age group and gender of the study population was 31-40 years (32%) with a female predilection (52%). The most common OFP was disc-condyle disorder (46%). Drowsiness (46%) was most reported adverse effect to TCA’s. A paired t test performed to assess the mean difference at 15,30 45 days after using TCA’s revealed p<0.01 with mean and SD as 4.400 ± 1.050; 1.956 ± 0.917; 0.577 ± 0.667, respectively. Low dose amitriptylines are more effective in management of OFP and its associated symptoms. It is more economical and less adverse effects reported.