![]() Pincus described the team’s findings as a global public health concern. “There was no reliable evidence on the safety of taking antidepressants for chronic pain, both short- and long-term,” the team said, adding it was also unclear whether antidepressants were effective at treating pain in the long term. ![]() The team add the average length of the various trials was just 10 weeks – despite patients often being prescribed antidepressants for six months. “Aside from duloxetine and milnacipran, we don’t have any confidence in the results from any other antidepressant in this review,” said Dr Hollie Birkinshaw, another author of the study from the University of Southampton. Milnacipran, which belongs to the same class of antidepressants as duloextine, also showed a small effect at reducing pain, but the team said they had lower confidence in these results because there were fewer studies involving fewer people. The results also suggest a standard dose is as effective as higher doses. Only duloxetine – a drug with many industry sponsored trials – had enough evidence for the researchers to have even moderate confidence in their findings, with the drug found to have a small to moderate effect on substantial pain relief. The team found that many of the trials involved very small numbers of patients, making the results unreliable. Patients experiencing mental health conditions, such as depression, were excluded from most trials. The review, conducted by Pincus and colleagues, looked at 176 randomised control trials involving nearly 30,000 patients.Īmong other drugs the trials included amitriptyline, a tricyclic antidepressant, selective serotonin reuptake inhibitors such as fluoxetine and citalopram, and duloxetine – a serotonin-noradrenaline reuptake inhibitor. “The fact that we don’t find evidence whether it works or not, is not the same as finding evidence that it doesn’t work,” she said.
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