A recent UK-based study has found that anti-depressants may not be the best approach to providing pain relief for people living with chronic pain. The study reviewed and analyzed studies that investigated the efficacy of 25 different antidepressants and found that the only antidepressant that might be useful in treating chronic pain is duloxetine. The team narrowed down 176 studies that included 28,664 people with chronic pain and found that out of 146 studies that revealed their sources of funding, pharmaceutical companies had funded 72 studies. These studies delved into whether antidepressants help in relieving pain among people living with fibromyalgia, nerve pain, and lower back pain.
The researchers found that for every 1000 people who were taking duloxetine for pain relief, 435 reported they experienced 50% of pain relief but the control group, or those who were given placebo treatment, also experienced 50% pain relief. The findings were published in the Cochrane Database of Systematic Reviews on May 10, 2023. In a press release, lead author of the study, Tamar Pincus, a professor at the University of Southampton said, “This is a global public health concern. Chronic pain is a problem for millions who are prescribed antidepressants without sufficient scientific proof they help, nor an understanding of the long-term impact on health.”
In another recent study published in the British Medical Journal, researchers reported that antidepressants were ineffective for treating pain conditions and that the evidence was “inconclusive.” The BMJ study also noted that there was some evidence for the efficacy of duloxetine when prescribed at doses between 60-120 mg for conditions like back pain, fibromyalgia, and neuropathic pain. The researchers’ conclusion stated: “Our findings suggest that a more nuanced approach is needed when prescribing antidepressants for pain.”
The study suggests that doctors commonly prescribe anti-depressants to people living with chronic pain. However, the researchers found that they are only confident in the effectiveness of one antidepressant, duloxetine. They highlighted that the “evidence for all other antidepressants was low certainty.” The researchers concluded that future research should address unwanted effects for any antidepressant as the data for this were very poor.