We thought antidepressants were useful for chronic pain… This is (almost) nothing
To avoid the prescription of opioids, antidepressants were used as pain relievers in some patients, but proved ineffective in most cases.
Against pain, logic dictates that we prescribe painkillers. But in the case of chronic pain, medicine has gradually turned to other options than opioids, known for their addictive potential and the related risk of overdose. Antidepressants have been seen as an interesting avenue against long-lasting pain, whose physiological cause was not always obvious. But a recent analysis published in the Cochrane database points out that they are largely useless, underlines 20 Minutes via a dispatch.
Worldwide, more than 100 million people suffer from chronic pain, according to the Pasteur Institute of Lille. “Pain is considered chronic when it has lasted for at least three months. Of more or less acute intensity, it can cause a profound alteration in the quality of life of those who suffer from it,” explains the Institute.
The most prescribed drug is not effective
Many studies have been conducted to find other ways of treating this pain. The Cochrane database publishes meta-analyses of studies that summarize the state of knowledge from everything that has been published in the scientific literature. In this case, on the link between anti-depressants and pain, the researchers summarized the observations of 176 studies, carried out on more than 30,000 patients and based on trials involving 25 molecules.
It emerged that the most prescribed antidepressant for chronic pain, amitroptyline did not provide conclusive results, in the same way as most of the other antidepressants tested. There is however an exception, duloxetine, which is the only one whose beneficial effects against pain are observedand possibly also milnacipran, although its action is less obvious.
But the scientists point out that there is still a lack of data on the side effects of these treatments, administered over the long term, in the context of this type of pain. They also specify that their results should not encourage no patient to stop treatment abruptly, without advice and support from their doctor for weaning.
Sources: Cochrane, 20 Minutes, AFP, Pasteur Institute of Lille