title: Acupuncture and myofascial pain: treatment failure after administration of tricyclic antidepressants.
abstract: A 63-year old depressed woman with a 2-year history of chronic pain on the right side of her face in the area of the zygomatic arch and temporomandibular joint received acupuncture before and after the medical treatment of her depression. During her unmedicated state electroacupuncture provided pain relief, while after prolonged intake of doxepin the treatment no longer produced analgesia. The literature fails to provide a mechanism explaining the differential responses to acupuncture with regard to antidepressant medication. Suggestions on further endorphin related research are made with particular emphasis on gonadotropin activity.
mesh_terms: D015670:Acupuncture Therapy; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D004316:Doxepin / Q000009:adverse effects*; D004723:Endorphins / Q000502:physiology; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000150:complications / Q000628:therapy*
chemical_list: D004723:Endorphins; D004316:Doxepin