Hundreds of thousands of people in the UK are being prescribed antidepressants for chronic pain without sufficient evidence they work, researchers have said. In the largest study of its kind, experts looked at medicines commonly prescribed on the NHS including amitriptyline, duloxetine, fluoxetine (Prozac), citalopram, paroxetine (Seroxat) and sertraline.
Amitriptyline is one of the most commonly prescribed antidepressants for chronic pain in England, with the NHS website saying it can treat nerve pain, some back pain and can help prevent migraines. But the new study, which included 176 trials and almost 30,000 patients, concluded that only duloxetine had reliable evidence for pain relief.
Researchers, including from the universities of Southampton, Bath, Bristol and University College London, also raised concerns about the lack of long-term data on safety. The National Institute for Health and Care Excellence (Nice) recommends a range of antidepressants as an option for chronic primary pain (where the underlying cause is unknown) and neuropathic pain such as neuralgia, some cancer pain and conditions that can cause neuropathic pain such as stroke, spinal cord injury and multiple sclerosis.
