2023-05-11 10:15:00
Fibromyalgia, osteoarthritis, neuropathic pain… Approximately a third of French people are handicapped on a daily basis by chronic pain. One of the treatments for these pains that persist for more than three months: taking antidepressants. But according to a study published in the Cochrane review, thehe vast majority of antidepressants have not proven their effectiveness in the treatment of chronic pain (source 1). This meta-analysis is the result of the compilation of 176 studies carried out on nearly 30,000 patients, evaluating the effectiveness of 25 antidepressants prescribed against chronic pain.
The only antidepressant we know for treating chronic pain is duloxetine, the study researchers say.
The result is alarming: only one antidepressant, duloxetine, has shown therapeutic benefitwith a “weak to moderate effect for substantial pain relief,” the study shows.
Regarding the other antidepressants analyzed, “the milnacipran was often ranked as the second most effective antidepressant, although the certainty of the evidence was lower than that of duloxetine. There was insufficient evidence to draw strong conclusions about the efficacy and safety of any other antidepressants for chronic pain”.
The difficulty of managing chronic pain
Those who suffer from it know that chronic pain is difficult to treat. According to the High Authority for Health, 70% of French people suffering from chronic pain “do not receive appropriate treatment and less than 3% benefit from care in a specialized pain structure” (source 2).
Many treatments exist to combat chronic pain, but none are perfect. Anti-inflammatory drugs (NSAIDs) have significant risks of adverse effects at high doses. THE opiates, very effective against pain, present a high risk of dependence. Finally the antidepressants, contrary to the studies cited, are far from being systematically effective. “There is currently no no reliable evidence of long-term effectiveness of any antidepressant, and no reliable evidence of the safety of antidepressants for chronic pain,” recalls the study published in the Cochrane review. “No review has reported high-certainty evidence on the effects of antidepressants on pain,” confirms a study published in the BMJ Journal in February 2023 (source 3).
Nevertheless, patients on antidepressant treatment for chronic pain should not not stop their treatment without medical advice.
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