In 2021, U.K. health authoritiesrecommended againstusing any medication for pain management except for antidepressants.
But in the other 31 cases, antidepressants appeared ineffective for pain management, or the evidence was inconclusive.
Tricyclic acids (TCAs)are the most commonly prescribed class of antidepressants for pain.
Israel Sebastian / Getty Images
But the review found there is low certainty that these drugs are effectively treating any pain condition.
On the other hand, SNRIs appeared beneficial for people with seven pain conditions.
A person is not just a pain condition.
Some clinicians may turn to antidepressants to avoid prescribing opioids, which can be powerfully addictive.
Scientists dont yet know how antidepressants work to minimize pain.
A leading theory is that they increase the levels of certain neurotransmitters, which then reduce pain signals.
Hasoon said there can be stigma around pain management doctors prescribing antidepressants.
If you have chronic pain and youre in pain day after day 24/7, youre going to be depressed.
Theres so much comorbid depression and anxiety, that youre co-managing at the same time, Hasoon said.
Four of the 11 drug-condition comparisons for which there is moderate certainty of evidence involve these drugs.
The SNRI duloxetine is the onlyFDA-approvedantidepressant for neuropathic pain.
Its indicated for fibromyalgia, chronic musculoskeletal pain, and diabetic peripheral neuropathic pain.
Many of the studies covered by the review had different ways of gauging how well drugs worked.
The review gave efficacy estimates for the use of TCAs to reduce pain for 14 conditions.
Yong RJ, Mullins PM, Bhattacharyya N.Prevalence of chronic pain among adults in the United States.Pain.
2022;163(2):e328-e332.
2021;214(7):324-331. doi:10.5694/mja2.50992
Finnerup NB.Nonnarcotic methods of pain management.N Engl J Med.
2016;315(20):2230-2232. doi:10.1001/jama.2016.3445
