Is there evidence to support the following medical approaches to treatment of chronic pelvic pain?
Antidepressants Tricyclic antidepressants, such as imipramine, amitriptyline, desipramine, and doxepin, have been shown in placebo-controlled studies to improve pain levels and pain tolerance in some, but not all, chronic pain syndromes. It is not clear how effective other antidepressants, such as SSRIs, are in the treatment of chronic pain syndromes. At this time, evidence is insufficient to substantiate efficacy of antidepressants for the treatment of chronic pelvic pain. Nonetheless, the substantial association of depression with chronic pelvic pain supports the use of antidepressants for the specific treatment of depression. Local Anesthetic Injection of Trigger Points Chronic pain syndromes associated with myofascial trigger points have been clinically recognized for quite some time. Observational data on the use of local anesthetic injection of trigger points of the abdominal wall, vagina, and sacrum for relief of chronic pelvic pain have demonstrated a response rate of 68%. Anal
