Anti-Anxiety Meds, Antidepressants, and Opioids

Q. I’m 67 years old and have lived with chronic pain from an automobile accident for nearly 10 years. The pain has caused me to be depressed much of the time, and my primary-care doctor prescribed antidepressants and anti-anxiety meds along with an opioid pain medicine. I’ve taken this combination of medicines for eight years. At my last appointment, he was reluctant to renew the anti-anxiety prescription. The combination has worked for me, and I am worried now that I won’t have relief. Can you give me some advice about what to do?

You are caught between a rock and a hard place. Current research says that more than half of all older adults diagnosed with chronic pain during the last year also suffer from problems stemming from anxiety and depression. Many physicians thought prescribing a combination of opioids, antidepressants, and anti-anxiety medicines would be the best practice, but combining these classes of drugs is more difficult than was originally thought. Therefore, it is in your best interest to ask for a referral to a pain specialist who can work collaboratively with a psychiatrist to help find an optimal prescription for the pain, depression, and anxiety that will effectively address each of these conditions. While it may be a nuisance to find specialty practitioners, your overall health is essential.

Want to read more pain questions and answers? See our Pain Q&A section.

Our expert: Jackson Rainer is a board-certified clinical psychologist who practices with the Care and Counseling Center in Decatur, Georgia, helping people living with chronic illnesses. He consults with a variety of experts to answer a selection of readers’ questions in each issue of Pain-Free Living.

Have questions about living with and managing chronic pain? Email questions to [email protected]. Please put “PFL Q&A” in the subject line.

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