What Are Non-Opioid Analgesics?

The 3 Types of Non-Opioid Analgesics Used to Treat Chronic Pain

Tablets of aspirin in a bottle.
Tablets of aspirin in a bottle. Tim Boyle/Getty Images

Non-opioid analgesics are pain medications for mild to moderate pain. Non-opioid analgesics include NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen, as well as other analgesics such as acetaminophen and aspirin. These medications also include adjuvant analgesics, which are those that relieve pain even though pain relief is not their primary purpose. Examples of these adjuvant analgesics include antidepressants and anticonvulsants, both regularly used to treat certain types of chronic pain.

Non-opioid analgesics may be short-acting or long-acting pain medications. They may be taken alone for pain management or they may also be taken in combination with opioids to relieve moderate to severe pain.

Non-opioid analgesics, such as low-dose naproxen and aspirin, are readily available over-the-counter, though many stronger forms require a doctor’s prescription. A prescription is always required for adjuvant analgesics.

NSAIDs for Chronic Pain

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain by altering the sensation of pain by blocking certain enzymes that participate in the pain response. They also work to reduce swelling that is often associated with certain types of pain. Some NSAIDs, however, are only effective at reducing swelling when taken at higher doses.

NSAIDs for chronic pain include:

Antidepressants for Chronic Pain

Antidepressants are adjuvant analgesics.

They are not formulated specifically as pain medications, but they can effectively treat certain types of chronic pain. Some types of antidepressants, such as Monoamine oxidase inhibitors (MAOIs), are not useful as chronic pain medications.

Antidepressants are thought to control chronic pain in two ways.

First, they may change the way pain is perceived from the spinal cord to the brain. Second, they may decrease anxiety and help regulate sleep.

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. Depression medication is sometimes used to treat chronic headaches, such as migraines or tension headaches.

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

Anticonvulsants for Chronic Pain

Anticonvulsants, usually used to control seizure disorders, can also be used as pain medication. Anticonvulsants are also adjuvant analgesics. Because they work by inhibiting certain types of nerve transmissions, they can decrease neuropathic pain sensations, such as those caused by trigeminal neuralgia or diabetic neuropathy.

Anticonvulsants commonly used as pain medications include gabapentin and pregabalin.

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