Most of the medical conditions are association with an increased risk of depressive symptoms and disorders, particularly when the illness is chronic. Rheumatoid arthritis is a chronic progressive inflammatory disease affect 1% of the population worldwide. Depressive disorders occur in 20%-25% of patient with rheumatoid arthritis. In such causes specific DMARDs and standard analgesics (acetaminophen, NSAIDs and opioids) alone are ineffective. Lot of previous studies reported that some of the antidepressant possesses significant anti-inflammatory and anti-nociceptive action. In some of European countries officially approved and using amitriptyline in ankylosis spondylitis for pain relief and prevention for patients with frequent/chronic migraines (25-75 mg). Based on this knowledge our work explores the combination therapeutic effect of antidepressant with DMARD on pain associated depression in preclinical model. Result of this study is helpful for both researchers and physician toimprove the physical and psychological states of rheumatoid arthritis patients.
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