Fibromyalgia & musculoskeletal pain
Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews
Authors' conclusion
Evidence of efficacy of antidepressants was found in 11 of the 42 comparisons included in this overview of systematic reviews-seven of the 11 comparisons investigated the efficacy of SNRIs. For the other 31 comparisons, antidepressants were either inefficacious or evidence on efficacy was inconclusive.
Study context
- Population
- Adults with any pain condition (22 pain conditions); systematic reviews comparing any antidepressant with placebo26 reviews
- Participants
- >25,000 adults156 unique trials
- Comparison
- Any antidepressant vs placebo for any pain condition in adults
- Outcome
- Pain (0–100 scale); for headache disorders, frequency of headaches
- Follow-up
- Time point closest to the end of treatment
Methodological detailsGRADE certainty assessment, Two reviewers independently extracted data
- GRADE certainty assessment
- Two reviewers independently extracted data
Main finding
As reported in the abstract
Pain (0–100), efficacious comparisons with moderate certainty evidence (SNRIs vs placebo)
SNRIs vs PlaceboMean difference (95% CI)
Back pain
−5.3(−7.3 to −3.3)
Postoperative pain
−7.3(−12.9 to −1.7)
Neuropathic pain
−6.8(−8.7 to −4.8)
SNRIs vs PlaceboRelative risk (95% CI)
Fibromyalgia
1.4(1.3–1.6)
- Comparisons where antidepressants were efficacious (of 42; nine conditions)
- 11
- Comparisons not efficacious
- 5
- Comparisons inconclusive
- 26
Original publication
Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. BMJ. Published 1 February 2023. doi:10.
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