<I haven't ever heard of the use of a tricyclic antidepressant.  What is
the
rationale on that, Lisa?  You've got me curious.>

Barbara, low-dose tricyclics are often used in the treatment of
"neuropathic pain syndromes". These are syndromes where pain is experienced
due to a hypersensitivity of the nerve pathways (well, this is how I
describe it!). At the vulva clinic where I work once a  month we use it for
some women with vulvar pain (they start with 10mg amitriptyline at night
and increase gradually). The new antidepressants don't have the same
action.- see: The vulval pain syndromes. International Journal of STD &
AIDS 1998: 9: 74-79.
I have suggested trying this once or twice to women with persistent breast
thrush, but no-one has been interested yet.
Lisa Amir
GP / IBCLC in Melbourne, Australia