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Chronic pain is frequently comorbid with both anxiety and mood disorders. Although many pain medicine practitioners may not manage psychiatric conditions, it is increasingly important to have at least a rudimentary familiarity with first-line psychiatric medications used to treat anxiety and mood disorders, a class of medications that is commonly encountered by pain specialists.

The mnemonic AMPS, or anxiety, mood, psychosis, and substance abuse, can be used to describe which psychiatric conditions are more commonly seen in the outpatient setting. In this chapter, we focus on the medication management of anxiety and mood (including major depressive disorder and bipolar spectrum disorders) because these disorders often influence the short- and long-term prognosis of those with chronic and unexplained pain. Antipsychotic medications are also discussed because there is much overlap with this class and the treatment of bipolar disorder. Tables 76-1 and 76-2 provide a practical overview of these medications.

TABLE 76-1

Overview of the First-Line Antidepressants

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