May 11, 2023 – “This is a global public health concern,” said Tamar Pincus, lead author on the study and a professor at the University of Southampton. “Chronic pain is a problem for millions who are prescribed antidepressants without sufficient scientific proof they help, nor an understanding of the long-term impact on health.”

Investigators from several universities across the United Kingdom conducted a network meta-analysis to determine if antidepressants were effective for managing chronic pain and if there were any unwanted effects associated with their use. In total, 176 trials consisting of 28,644 people with chronic pain were included.

Studies in the meta-analysis investigated 89 different types or combinations of antidepressants for their effect on chronic pain conditions, such as fibromyalgia, nerve pain and musculoskeletal pain. The three most common medications that were examined were amitriptyline, duloxetine and milnacipran.

Primary outcomes were substantial (50%) pain relief, pain intensity, mood, and adverse events. Secondary outcomes included moderate pain relief (30%), physical function, sleep, quality of life, Patient Global Impression of Change (PGIC), serious adverse events, and withdrawal.