A large review of 176 trials involving nearly 30,000 patients found that there was “insufficient” evidence to suggest that antidepressants are an effective treatment for chronic pain.
The study, published in the Cochrane Database of Systematic Reviews, took a closer look at whether or not antidepressants like amitriptyline, fluoxetine, citalopram, paroxetine, sertraline, and duloxetine could be effective in treating certain chronic pain conditions. Millions of people are prescribed anti-depressants to help treat their chronic pain issue, and while many chronic pain conditions involve physical, mental and emotional aspects, it doesn’t necessarily mean jumping on an anti-depressant regimen is helpful.
After conducting the meta-review, researchers were quick to question the efficacy of anti-depressants to treat chronic pain.
“Our review found no reliable evidence for the long-term efficacy of any antidepressant, and no reliable evidence for their safety for chronic pain at any point. Though we did find that duloxetine provided short-term pain relief for patients we studied, we remain concerned about its possible long-term harm due to the gaps in current evidence,” said lead author Professor Tamar Pincus from the University of Southampton.
The two-year study was the largest-ever assessment of anti-depressants currently recommended by the Food and Drug Administration and the UK’s National Institute for Health and Care Excellence (NICE).
Anti-Depressants And Chronic Pain Management
So while there is some clear doubt about the effectiveness of common anti-depressants for chronic pain management, you shouldn’t just stop your current medication regimen if you are on an anti-depressant. You should always consult with your physician before altering your medication schedule, because stark changes can actually lead to more issues.
Additionally, the review isn’t meant to suggest that you should never take an anti-depressant if you have chronic pain. As we mentioned above, chronic pain is rarely just physical, so it is important to care for your mental health as you work through a physical pain issue. That said, anti-depressants should not be your sole treatment plan. Anti-depressants may play a vital role in a comprehensive treatment plan, but they are unlikely to be a great stand-alone option.
Paired with treatments like physical therapy, dietary changes, sleep improvements and cognitive behavioral therapy, it’s certainly possible that anti-depressants may be helpful for your specific situation. Again, their use needs to be evaluated on an individual basis, and it should not be the treatment that you put the most energy towards. There are many other treatments that have been found to be much more effective at treating chronic pain conditions, and we’d be more than happy to help find the right treatment for you.
For more information, or to work with a pain management provider to find a treatment plan that’s right for you, reach out to Dr. Cohn and his team today at (952) 738-4580.