Antidepressants and Back Pain

Jan. 18, 2002 (Ivanhoe Newswire) -- Patients with chronic back pain may mildly benefit from taking antidepressants, according to a recent study, but the side effects may outweigh the benefits.

Researchers with the U.S. Departments of the Navy and Army reviewed data collected from nine different trials between 1966 and 2000 to evaluate the use of antidepressants in patients with chronic back pain. While the medications seemed to alleviate back pain significantly, they did not improve a patient's ability to return to the functions of daily life any sooner.

Up to 50 percent of working adults experience back pain every year, although most patients improve within three months. However, those people with persistent and chronic back pain regularly suffer serious disability, often accounting for huge medical costs. While a variety of therapies may help prolonged back pain -- including acupuncture, narcotics, and electrical nerve stimulation -- conflicting evidence has suggested antidepressants may provide relief as well. Researchers note there are several theories why antidepressants may work, such as altering a patient's perception of pain, treating an underlying case of depression, or improving sleep.

While the study did find a small but significant change in pain levels among patients taking antidepressants, the adverse effects of the antidepressant medications may outnumber this minor improvement. Drowsiness, dry mouth, dizziness and constipation were reported by more than 20 percent of the patients surveyed, as compared to only 14 percent of the control group. Further, the patients taking antidepressants did not show any more improvement in performing daily activities.

Researchers write, "Larger, better-designed randomized control trials that weigh the benefits and adverse effects of antidepressant therapy are needed before the use of antidepressants can be routinely recommended as therapy for back pain in patients without depression."

SOURCE: Archives of Internal Medicine, 2002;162:19-24