抗抑郁药物治疗腰部疼痛和脊柱相关的腿部疼痛
Michael C Ferraro1,2, Donna M Urquhart3, Giovanni E Ferreira4,5
1Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia.
The Cochrane database of systematic reviews
|March 9, 2025
概括
像SNRIs这样的抗抑郁药对腰部疼痛可能有很小的益处,但会带来风险. 与脊柱相关的腿部疼痛和其他抗抑郁药类的证据仍然不确定,强调需要更多的研究.
科学领域:
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 抗抑郁药经常被处方用于腰部疼痛和相关腿部疼痛.
- 这些药物对这些疾病的疗效和安全性尚未确定.
- 这项研究更新了2008年之前的Cochrane审查.
研究的目的:
- 评估抗抑郁药在患有非特异性腰部疼痛和脊柱相关腿部疼痛的患者中使用抗抑郁药的益处和危害.
- 综合来自随机对照试验的证据,比较抗抑郁药与安慰剂或常规护理.
主要方法:
- 在多个数据库 (CENTRAL,MEDLINE,Embase等) 中进行系统搜索. 这项研究将持续到2024年11月.
- 包括非特异性腰部疼痛或脊柱相关腿部疼痛的成年人随机对照试验 (RCT).
- 提取和分析了关于疼痛强度,残疾和不良事件的数据,并使用GRADE评估证据的确定性.
主要成果:
- 对于非特异性腰部疼痛,色胺和上腺素再吸收抑制剂 (SNRIs) 显示了对疼痛小效应和对残疾微不足道影响的中度确定性证据,可能会产生不良影响.
- 三环抗抑郁药 (TCA) 显示了对残疾的小影响的中度确定性证据,但对疼痛强度的影响很小或不存在.
- 对选择性血清素再吸收抑制剂 (SSRI),四环抗抑郁药 (TeCA) 和其他抗抑郁药物的证据确定性低至非常低,对脊柱相关的腿部疼痛的益处和危害不确定.
结论:
- SNRIs可能对腰部疼痛提供适度的益处,但与不良事件有关.
- 在腰部疼痛中,TCA可能会为残疾提供一个小的好处.
- 大多数抗抑郁药对脊柱相关腿部疼痛和某些类别的腰部疼痛的有效性和安全性的证据基础是有限的和不确定的.
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