People who see their doctor to get something for their chronic pain are likely to be handed an antidepressant drug that won’t work.
A major review has discovered that doctors are routinely prescribing antidepressants for fibromyalgia, and nerve and muscle pain—even though there is no evidence any of them work.
The only antidepressant that has some evidence of being an effective pain-reliever is duloxetine, a SNRI (serotonin–norepinephrine reuptake inhibitor) that’s marketed as Cymbalta, say researchers from the Cochrane Review—but it’s so expensive that it is rarely prescribed to treat pain.
Amitriptyline, a tricyclic antidepressant marketed as Elavil, is the drug most doctors turn to, but there’s no evidence at all that it helps relieve pain.
The researchers reviewed 176 studies that had tracked the care of more than 28,000 patients suffering from chronic pain; none of them had depression or anxiety.
Antidepressant prescribing for chronic pain started when doctors became worried about escalating opioid painkiller addiction and were looking for pharmaceutical alternatives. Antidepressants were thought to alleviate pain because the same chemicals affect mood and pain.