Which medications in the drug class Antidepressants, TCAs are used in the treatment of Foot Drop?

Updated: Jun 21, 2018
  • Author: James W Pritchett, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

Antidepressants, TCAs

The analgesic properties of certain agents in this class may improve symptoms if painful paresthesias develop.

Amitriptyline

Amitriptyline is an analgesic for certain chronic and neuropathic pain. It blocks the reuptake of norepinephrine and serotonin, which increases their concentration in the central nervous system (CNS). Amitriptyline decreases pain by inhibiting spinal neurons involved in pain perception. This agent is highly anticholinergic. It is often discontinued because of somnolence and dry mouth. Cardiac arrhythmia, especially in overdose, has been described; monitoring the QTc interval after reaching the target level is advised. Up to 1 month may be needed to obtain clinical effects.

Nortriptyline (Pamelor)

Nortriptyline increases the concentration of serotonin and norepinephrine in the central nervous system by inhibiting their reuptake by the presynaptic neuronal membrane. It has demonstrated effectiveness in the treatment of chronic pain.

Desipramine (Norpramin)

This is the original tricyclic antidepressant used for depression. These agents have been suggested to act by inhibiting reuptake of noradrenaline at synapses in central descending pain modulating pathways located in the brainstem and spinal cord.


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