The Effect of Antidepressant Treatment on Chronic Back Pain

Abstract

Antidepressants are more effective than placebo in reducing pain severity but not functional status in chronic back pain.

Outcome of non-invasive treatment modalities on back pain: an evidence-based review

“…Most of these reviews were published [6,42,76,78,83,88,90,135,146,190,192], but preliminary results from one Cochrane review on patient education (A. Engers et al, submitted for publication) that has been submitted for publication were also used. Because no Cochrane review was available, we used two recently published systematic reviews for the evidence summary on antidepressants [161,170]. The Cochrane review on work conditioning, work hardening, and functional restoration [163] was not taken into account because all trials included in this review were also included in the reviews on exercise therapy and multidisciplinary treatment.…”

Chapter 4 European guidelines for the management of chronic nonspecific low back pain

“…The two trials on selective serotonin reuptake inhibitors showed that the latter were not effective. The second review (Salerno et al 2002) concluded that patients with antidepressants were significantly more likely to improve in pain severity than those taking placebo (0.41; 95%confidence interval, 0.22-0.61) but not in activities of daily living (0.24; 95% confidence interval, -0.21-0.69).…”

“…Two high quality systematic reviews (Salerno et al 2002 concluded that noradrenergic-serotonergic and noradrenergic antidepressants are more effective than selective serotonin reuptake inhibitors (which seem to have no effect).…”

Pharmacotherapy for Chronic Low Back Pain

“…Two systematic reviews concluded that tricyclic antidepressants have modest beneficial effects on pain but limited effects on functional status (Salerno et al, 2002;Staiger et al, 2003).…”