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Antidepressants are widely used in treating pain globally, and now new research had shown that their impact on people with chronic back pain and osteoarthritis is minimal. The study by University of Sydney researchers revealed that antidepressants could also have adverse events.

Antidepressants use in pain treatment growing globally

Millions of people globally suffer from knee osteoarthritis and back pain, which are leading disability causes. When first-line treatments such as ibuprofen and paracetamol fail to alleviate symptoms, most people turn into antidepressants. Although clinical practice guidelines advise the use of antidepressants in managing hip and knee osteoarthritis and back pain, there is little evidence supporting their use.

The study published in the BMJ evaluated antidepressants ‘ safety and efficacy in back pain and osteoarthritis treatment relative to placebo. The researchers expect the study to help patients and clinicians decide whether they use antidepressants in chronic back pain and knee osteoarthritis treatment.

Antidepressants ineffective in chronic pain treatment

Lead study author Dr. Giovanni Ferreira said that antidepressant use in knee osteoarthritis and chronic back pain treatment has increased globally in recent times. Ferreira said that it is unclear whether the antidepressants can alleviate the pain and thus they sought to study their safety and efficacy in patients with knee osteoarthritis and chronic back pain. He said that their study established that antidepressants were ineffective in this patient group, and they had a minimal impact that most patients are unlikely to perceive worthwhile. Ferreira added that the effect of antidepressants on osteoarthritis patients was small, but some patients could consider it as worthwhile.

This is concerning considering some antidepressants can substantially increase adverse events risk. Most people treated with the medications may not benefit from easing pain, and the antidepressants can do them harm.

Researchers evaluated 33 randomized controlled studies in a systemic review covering over 5,000 subjects with low back or neck pain, hip or knee osteoarthritis. The study evaluated six antidepressant classes including, tricyclic and serotonin-noradrenaline reuptake inhibitors (SNRIs) antidepressants.