ANTIDEPRESSANTS IN THE MANAGEMENT OF OROFACIAL PAIN: A NARRATIVE REVIEW OF CLINICAL EVIDENCE
DOI:
https://doi.org/10.66104/fcx4vv60Keywords:
Antidepressants; Orofacial Pain; Temporomandibular Disorders; Amitriptyline; Duloxetine.Abstract
Orofacial pain is a complex and multifactorial clinical condition, frequently associated with temporomandibular disorders, neuropathic pain, and psychosocial factors, which may significantly impair patients’ quality of life. Conventional therapies, primarily based on analgesics and anti-inflammatory drugs, do not always provide satisfactory outcomes, particularly in chronic cases, thereby encouraging the search for alternative pharmacological approaches. This study aimed to analyze the use of antidepressants in the treatment of orofacial pain and to discuss their implications for dental practice. A narrative literature review was conducted using the PubMed, SciELO, and Virtual Health Library (VHL) databases, including clinical studies, systematic reviews, and meta-analyses. After a selection process based on predefined eligibility criteria, 13 studies were included in the qualitative analysis. Findings suggest that tricyclic antidepressants, such as amitriptyline, and serotonin-norepinephrine reuptake inhibitors, such as duloxetine and milnacipran, may contribute to pain reduction and improvement in quality of life, particularly in conditions involving central sensitization and affective comorbidities. However, evidence specifically addressing orofacial pain remains limited and is partly extrapolated from other chronic pain syndromes. It is concluded that antidepressants represent a relevant therapeutic option for the management of orofacial pain, provided that their prescription is individualized and accompanied by appropriate clinical monitoring.
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Copyright (c) 2026 Ana Paula Oliveira Rocha, Flávia Cordeiro Antunes , Millena Alberto Luna , Raissa Danielle Muniz da Silva , Gustavo Henrique Palma Durães , Lorena Miranda Lima , Agda Silene Leite , Barbara Quadros Tonelli , Guilherme Gonçalves da Silva
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