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Drugs

, Volume 68, Issue 18, pp 2611–2632 | Cite as

Antidepressants for the Treatment of Chronic Pain

  • Bénédicte Verdu
  • Isabelle Decosterd
  • Thierry Buclin
  • Friedrich Stiefel
  • Alexandre Berney
Review Article

Abstract

Chronic pain represents one of the most important public health problems and, in addition to classical analgesics, antidepressants are an essential part of the therapeutic strategy. This article reviews available evidence on the efficacy and safety of antidepressants in major chronic pain conditions; namely, neuropathic pain, headaches, low back pain, fibromyalgia, irritable bowel syndrome (IBS) and cancer pain. Studies, reviews and meta-analyses published from 1991 to March 2008 were retrieved through MEDLINE, PsycINFO and the Cochrane database using numerous key words for pain and antidepressants. In summary, evidence supports the use of tricyclic antidepressants in neuropathic pain, headaches, low back pain, fibromyalgia and IBS. The efficacy of the newer serotonin and norepinephrine reuptake inhibitors is less supported by evidence, but can be recommended in neuropathic pain, migraines and fibromyalgia. To date, evidence does not support an analgesic effect of serotonin reuptake inhibitors, but beneficial effects on well-being were reported in several chronic pain conditions. These results are discussed in the light of current insights in the neurobiology of pain, the reciprocal relationship between pain and depression, and future developments in this field of research.

Keywords

Migraine Chronic Pain Neuropathic Pain Irritable Bowel Syndrome Fibromyalgia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

We thank Temugin Berta (Isabelle Decosterd’s laboratory) for the art work in figure 1. Isabelle Decosterd is supported by the Swiss National Science Foundation (grant # 112577/1) and the Pierre Mercier Science Foundation. The authors have not conflicts of interest that are directly relevant to the content of this review.

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Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  • Bénédicte Verdu
    • 1
  • Isabelle Decosterd
    • 2
    • 3
  • Thierry Buclin
    • 4
  • Friedrich Stiefel
    • 1
  • Alexandre Berney
    • 1
  1. 1.Department of PsychiatryUniversity Hospital Center and University of LausanneLausanneSwitzerland
  2. 2.Pain Research Unit, Department of AnesthesiologyUniversity Hospital Center and University of LausanneLausanneSwitzerland
  3. 3.Department of Cell Biology and MorphologyUniversity Hospital Center and University of LausanneLausanneSwitzerland
  4. 4.Division of Clinical Pharmacology and ToxicologyUniversity Hospital Center and University of LausanneLausanneSwitzerland

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