Which of the following medications is NOT typically used for depression with comorbid pain?

The correct answer is Escitalopram, which is primarily classified as a selective serotonin reuptake inhibitor (SSRI) and is most commonly used to treat depression and anxiety disorders. While SSRIs like Escitalopram can be effective for managing depression, they are not typically the first line of treatment for patients with comorbid pain conditions.

In contrast, the other medications listed—Duloxetine, Venlafaxine, and Amitriptyline—have characteristics that make them more appropriate for treating both depression and pain. Duloxetine and Venlafaxine are serotonin-norepinephrine reuptake inhibitors (SNRIs) that are effective in treating both depression and various types of pain, including neuropathic pain and fibromyalgia. Amitriptyline, a tricyclic antidepressant, has long been used for its analgesic properties as well as for depression, particularly in headache disorders and chronic pain syndromes.

In summary, Escitalopram’s lack of direct analgesic effects and its primary focus on mood disorders positions it as the medication least suited for treating depression alongside comorbid pain compared to the other options that have dual efficacy.