The majority of antidepressants prescribed for chronicpain lack sufficient evidence of efficacy and safety, results of a large Cochrane review show.
Duloxetine was consistently the highest-ranked antidepressant and was equally effective for fibromyalgia, musculoskeletal, and neuropathic pain conditions, with moderate- to high-certainty evidence, the researchers found.
Milnacipran also appeared to be effective at reducing pain, but"we are not as confident in this result as duloxetine because there were fewer studies with fewer people," Birkinshaw noted."Aside from duloxetine and milnacipran, we do not have confidence in the results from any other antidepressant included in this review. This includes amitriptyline, even though it's the most common antidepressant used clinically," Birkinshaw added.
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