An unprecedented study on the effect of antidepressants on chronic pain was published Wednesday in the Cochrane database. And the result is clear: "Duloxetine is the only antidepressant whose interest is unmistakable against chronic pain." The researchers evaluated the potential benefits of 25 molecules and compiled 176 studies from a total of some 30,000 patients.
Chronic pain is defined as pain that lasts beyond several months, sometimes without a specific physiological cause, as in fibromyalgia. It can be the sequelae of a disease or an operation, or a side effect of a treatment, especially against cancer ...
An alternative to opioids
Opioids, long prescribed against these pains, are less and less so because of the proven risk of addiction and sometimes fatal overdoses. Doctors have therefore turned to antidepressants, with the idea that these molecules, developed to act on mood, are also effective against pain.
Cochrane, a large collaborative database, regularly publishes reference work to summarize the state of knowledge on a given medical topic. In this study, only duloxetine appears to have an indisputable benefit, although the authors point to the lack of data on its long-term side effects.
Do not stop treatment
Another antidepressant, milnacipran, seems to have proven effects but with less certainty. For the rest, the study concludes that there is a lack of evidence, especially on amitroptyline, one of the most prescribed antidepressants for chronic pain.
Despite these results, the researchers called on patients at a press conference not to stop their treatment without medical advice. This would be "really dangerous," said the study's lead author, pain specialist Tamar Pincus, recalling that abrupt withdrawal can have deleterious effects.
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