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Related Experiment Videos

Evidence-based data on pain relief with antidepressants.

D Fishbain1

  • 1University of Miami School of Medicine, Department of Psychiatry, University of Miami Comprehensive Pain and Rehabilitation Center at South Shore Hospital, USA. cprc@um-cprc.com

Annals of Medicine
|August 19, 2000
PubMed
Summary
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Antidepressants show analgesic effects for chronic pain, particularly neuropathic pain, independent of mood improvement. Serotonin-norepinephrine reuptake inhibitors may offer more consistent pain relief than selective serotonin reuptake inhibitors.

Area of Science:

  • Pharmacology
  • Pain Management
  • Neurology

Background:

  • Chronic pain affects millions globally, often inadequately managed by conventional analgesics.
  • Antidepressants are increasingly explored for non-mood-related conditions, including chronic pain.
  • The precise mechanism of antidepressant antinociception independent of antidepressant effects requires clarification.

Purpose of the Study:

  • To systematically review evidence on the antinociceptive (pain-relieving) effects of antidepressants in chronic pain.
  • To determine if these effects are independent of the drugs' antidepressant properties.
  • To identify specific chronic pain conditions and antidepressant classes with significant antinociceptive potential.

Main Methods:

  • Structured review of human acute pain studies.

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  • Analysis of individual placebo-controlled trials for specific chronic pain syndromes.
  • Inclusion of meta-analytic studies to synthesize evidence.
  • Tabulation and analysis of reviewed data.

    • Main Results:

    • Consistent evidence suggests antidepressants possess antinociceptive effects in chronic pain.
    • Significant efficacy was observed for neuropathic pain.
    • Antidepressants showed potential for psychogenic or somatoform disorder-associated pain.
    • Serotonergic-noradrenergic antidepressants demonstrated more consistent antinociceptive effects than serotonergic antidepressants.
    • Efficacy noted for chronic low back pain, osteoarthritis, rheumatoid arthritis, fibromyalgia, and ulcer healing.

    Conclusions:

    • Antidepressants offer a viable therapeutic option for managing various chronic pain conditions.
    • The antinociceptive effects appear distinct from their mood-regulating actions.
    • Further research is warranted to elucidate mechanisms and optimize treatment strategies, considering specific drug classes and pain phenotypes.