My approach would be to do more research and make sure there are really no other choices than be in pain or take a powerful antidepressant. In non-crisis situations it makes sense to start with the least dangerous interventions and work from there. Less dangerous approaches might include: magnesium and iron supplementation, eliminating caffeine, working on a very regulated schedule with time every day for exercise, working on sleep hygiene like having screen free time for at least two hours before bed, biofeedback, talk therapy to work on better stress management, keeping a journal to look at food or other lifestyle triggers, getting a sleep study to get a clearer idea what is going on with his sleep, etc.
As far as the fear of medication, I would attempt to encourage more critical thinking about it. If he's regularly taking Motrin he's already doing something dangerous. The fact that something is over the counter doesn't make it safe and the fact that something is prescription doesn't make it dangerous. As a person sensitive to medication I've developed some approaches that work for me. The first is as I said about to research and implement lifestyle changes as they often are as effective as prescription medication. If I feel I need to take a prescription and there are choices I prefer a medication that has been on the market longer so there is more of a track record. One good thing if he decides to take this medication is that tricyclic antidepressants have been around for a long time so there has been plenty of research. Also, they are typically prescribed with very low starting doses and that would be one of my suggestions for medication sensitive people is to see if they can try a smaller dose as a start. When you are looking at the side effects you may want to explore with the pharmacist if these are more likely at higher doses. If he does decide to take the tricyclic it would be a good idea to keep a very close eye on weight gain.
