Daily Pharmacy News

Get your free subscription started now. Just enter your email address below.

Overview of Antidepressant Use for Pain in Adults

Antidepressants were significantly effective for treating pain in adults in about one-quarter of the comparisons included in an overview of systematic reviews of placebo-controlled trials. “For the other 31 comparisons, antidepressants were either inefficacious or evidence on efficacy was inconclusive,” the authors conclude. “The findings suggest that a more nuanced approach is needed when prescribing antidepressants for pain conditions.”

Overall, the report covers 156 unique trials of more than 25,000 participants. Based on a main outcome measure of pain or frequency of headaches, the overview provides these insights: “These reviews reported on the efficacy of eight antidepressant classes covering 22 pain conditions (42 distinct comparisons). No review provided high certainty evidence on the efficacy of antidepressants for pain for any condition. 11 comparisons (nine conditions) were found where antidepressants were efficacious, four with moderate certainty evidence: serotonin-norepinephrine reuptake inhibitors (SNRIs)  for back pain (mean difference −5.3, 95% confidence interval −7.3 to −3.3), postoperative pain (−7.3, −12.9 to −1.7), neuropathic pain (−6.8, −8.7 to −4.8), and fibromyalgia (risk ratio 1.4, 95% confidence interval 1.3 to 1.6). For the other 31 comparisons, antidepressants were either not efficacious (five comparisons) or the evidence was inconclusive (26 comparisons).”

Source: BMJ