What are Adjuvant Analgesics?

Some Antidepressants and Anticonvulsants Can Be Used to Treat Chronic Pian

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An adjuvant analgesic is a medication that is not primarily designed to control pain, but can be used for this purpose. Some examples of adjuvant analgesics are medications like antidepressants and anticonvulsants.

You might be prescribed an adjuvant analgesic in addition to other pain medications, or on its own. Adjuvant analgesics tend to be less effective for musculoskeletal pain, such as back pain or joint pain.

However, they can work well for neuropathic pain and pain syndromes, such as fibromyalgia.

Unlike many other non-opioid analgesics, adjuvant analgesics are not available over the counter.

Types of Adjuvant Analgesics


While antidepressants are not often thought of as pain medication, they can effectively treat chronic pain conditions. Antidepressants are thought to control the way pain is perceived from the spinal cord to the brain. In addition, antidepressants may decrease anxiety and help regulate sleep.

However, not all types of antidepressants are effective in managing chronic pain. Tricyclic antidepressants (TCAs) such as amitriptyline, selective serotonin reuptake inhibitors (SSRIs), like duloxetine, and others, such as nefazodone, are commonly used to treat both chronic pain syndromes and nerve pain. Monoamine oxidase inhibitors (MAOIs) are not as effective in chronic pain control.


Anticonvulsants, which are medications most commonly used to control seizure disorders, can also be used to treat chronic pain. Anticonvulsants work by not allowing certain types of nerve transmissions, and they can decrease neuropathic pain, such as those caused by trigeminal neuralgia or diabetic neuropathy.

Anticonvulsants commonly used to manage chronic pain include gabapentin and pregabalin.

What Pain Syndromes Do Adjuvant Analgesics Treat?

The Oxford Textbook of Palliative Medicine lists the following Adjuvant Analgesics to treat the below pain syndromes:

Multiple types of pain syndromes can be treated with the following:

  • Corticosteroids
  • dexamethasone
  • prednisone
  • Tricyclic antidepressants*
  • amitriptyline
  • desipramine
  • Selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants*
  • duloxetine
  • milnacipran
  • Alpha-2-adrenergic agonists*
  • tizanidine*
  • Topical therapies
  • Local anesthetics

Neuropathic pain can be treated with the following:

  • Antiepileptic agents
  • gabapentin
  • pregabalin
  • carbamazepine
  • phenytoin
  • valproic acid
  • clonazepam
  • lamotrigine
  • topiramate
  • tiagabine
  • oxcarbazepine
  • lacosamide
  • NMDA receptor antagonists
  • memantine
  • ketamine
  • dextromethorphan
  • Oral sodium channel blockers
  • mexiletine
  • tocainide
  • baclofen
  • calcitonin

Complex Regional Pain Syndrome can be treated with the following:

  • Calcitonin
  • Clonidine
  • Prazosin Bone pain from cancer Bisphosphonates (e.g., pamidronate)
  • Calcitonin
  • Radiopharmaceuticals

Other articles about managing chronic pain with adjuvant analgesics:


Lussier D, Portenoy RK: Adjuvant analgesics. In Doyle D, Hanks G, Cherny NI, Calman K (eds): Oxford Textbook of Palliative Medicine. Oxford: Oxford University Press, Third Ed, Oxford: Oxford University Press, 2004, pp 349-377.

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