Shot of a senior woman in a wheelchair looking sad, depressed at a nursing home

Some antidepressants may be quite effective when used to treat certain types of chronic pain, but there is not enough evidence to vouch for the usefulness of others, investigators say.

Researchers reviewed 26 studies dated from 2012 to 2022, including more than 25,000 participants. Their analysis considered eight antidepressant classes and 22 pain conditions, such as back pain, fibromyalgia, headaches, postoperative pain and irritable bowel syndrome. 

The drug classes with the most evidence for reducing pain in the widest array of pain conditions included serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine.

In contrast, there was little to no evidence that tricyclic antidepressants such as amitriptyline were effective. Yet drugs in this class are among those most commonly used to treat pain, the researchers said.

There is a role for antidepressants in helping people living with chronic pain, but it appears to be more limited than previously thought, said Martin Underwood, from the University of Warwick, UK, in a statement. 

“We need to work harder to help people manage their pain and live better, without relying on the prescription pad,” he concluded.

The study was published in the BMJ.

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