BEYOND THE BRAIN BLOG
  • Blog
  • Author
  • Resources
    • Bookstore
    • Downloads
    • Provider Tools
    • Patient Resources
    • Speakers & Talks
    • Ketogenic Diet
  • For Patients
  • Contact

Abstract: Efficacy of antidepressants for back pain and osteoarthritis

2/1/2021

0 Comments

 
SOURCE: BMJ - British Medical Journal

Title: Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis
Authors: Giovanni E Ferreira, Andrew J McLachlan et al.
Picture
OBJECTIVE
​To investigate the efficacy and safety of antidepressants for back and osteoarthritis pain compared with placebo.


DESIGN
Systematic review and meta-analysis.


DATA SOURCES
Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, International Pharmaceutical Abstracts, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform from inception to 15 November and updated on 12 May 2020.


ELIGIBILITY CRITERIA FOR STUDY SELECTION
Randomized controlled trials comparing the efficacy or safety, or both of any antidepressant drug with placebo (active or inert) in participants with low back or neck pain, sciatica, or hip or knee osteoarthritis.

DATA EXTRACTION AND SYNTHESIS
Two independent reviewers extracted data. Pain and disability were primary outcomes. Pain and disability scores were converted to a scale of 0 (no pain or disability) to 100 (worst pain or disability). A random effects model was used to calculate weighted mean differences and 95% confidence intervals. Safety (any adverse event, serious adverse events, and proportion of participants who withdrew from trials owing to adverse events) was a secondary outcome. Risk of bias was assessed with the Cochrane Collaboration's tool and certainty of evidence with the grading of recommendations assessment, development and evaluation (GRADE) framework.


RESULTS
33 trials (5318 participants) were included. Moderate certainty evidence showed that serotonin-noradrenaline reuptake inhibitors (SNRIs) reduced back pain (mean difference -5.30, 95% confidence interval -7.31 to -3.30) at 3-13 weeks and low certainty evidence that SNRIs reduced osteoarthritis pain (-9.72, -12.75 to -6.69) at 3-13 weeks. Very low certainty evidence showed that SNRIs reduced sciatica at two weeks or less (-18.60, -31.87 to -5.33) but not at 3-13 weeks (-17.50, -42.90 to 7.89). Low to very low certainty evidence showed that tricyclic antidepressants (TCAs) did not reduce sciatica at two weeks or less (-7.55, -18.25 to 3.15) but did at 3-13 weeks (-15.95, -31.52 to -0.39) and 3-12 months (-27.0, -36.11 to -17.89). Moderate certainty evidence showed that SNRIs reduced disability from back pain at 3-13 weeks (-3.55, -5.22 to -1.88) and disability due to osteoarthritis at two weeks or less (-5.10, -7.31 to -2.89), with low certainty evidence at 3-13 weeks (-6.07, -8.13 to -4.02). TCAs and other antidepressants did not reduce pain or disability from back pain.


CONCLUSION
Moderate certainty evidence shows that the effect of SNRIs on pain and disability scores is small and not clinically important for back pain, but a clinically important effect cannot be excluded for osteoarthritis. TCAs and SNRIs might be effective for sciatica, but the certainty of evidence ranged from low to very low.


0 Comments

Your comment will be posted after it is approved.


Leave a Reply.

    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture


    USEFUL LINKS

    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture

    Archives

    December 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    August 2017
    January 2017
    November 2016
    September 2016
    August 2016
    July 2016
    May 2016
    March 2016
    February 2016
    December 2015
    November 2015
    October 2015
    September 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013


    following

    Picture
Creative Commons License
Copyright 2013
Beyond the Brain Blog
Beyond the Brain is a not-for-profit website. We appreciate your support to continue providing more content and tools.    Donate today!
BLOG  |  AUTHOR |  RESOURCES |  FOR PATIENTS |  CONTACT  |  SUPPORT BTB