Should Antidepressants Be Used to Treat Children in Chronic Pain?
For many young people, pain is a part of their lives. The World Health Organization acknowledges that pain in children is a major public health concern in most parts of the world.
According to the Journal of Pain Management, up to one-quarter of children have experienced pain the past three months. In the past, pain was mostly ignored in children with the belief that the pain was just temporary and something they would forget or outgrow. As a result, we know relatively little about the pain management needs of children.
We know even less about the efficacy of using antidepressants to treat pain in children. Antidepressants have been used to treat pain in adults for decades. However, the evidence for the benefits of this class of medication for pain relief in children is very limited.
In one study published in 2007, antidepressants were not effective in treating juvenile arthritis pain. However, there were only six participants in the study. In another study published two years later in 2009, there was no significant difference between an antidepressant and a placebo on gastrointestinal pain experienced by the children in the study.
With the lack of evidence, it may be wise to think about the following if you are considering trying an antidepressant for the treatment of pain in your child:
1. All moderate and severe pain in children should always be addressed. If you are seeing a doctor who you feel is not taking your child’s pain seriously, it may be time for another opinion.
2. Children are different than adults. Their perception of pain may be different. They are also growing and have a wide range of hormones that can vary from week to week. Finding the right medication for your child may be tricky and can take time and patience.
3. For adults and children, pain is extremely complicated and is very individual. It is perfectly normal that one day pain can be manageable and the next day not tolerable. This is true for adults and children, but children may have a more difficult time making sense of this.
4. Medical research on children can be difficult to accomplish for many different reasons. This means that we know very little about the ways in which your child will react to a medication, especially a depression medication. It is therefore important that you are seeing a physician that knows there are more questions than answers when it comes to pediatric pain and who can be patient with you and your child as you try to find a solution together.
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