Antidepressant analgesics

Watson, C. Peter N., Gilron, Ian, Pollock, Bruce G., Lipman, Arthur G. and Smith, Maree T. (2013). Antidepressant analgesics. In Stephen B. McMahon, Martin Koltzenberg, Irene Tracey and Dennis C. Turk (Ed.), Wall and Melzack's textbook of pain 6th ed. (pp. 465-496) Philadelphia, United States: Elsevier Saunders.

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Name Description MIMEType Size Downloads
Author Watson, C. Peter N.
Gilron, Ian
Pollock, Bruce G.
Lipman, Arthur G.
Smith, Maree T.
Title of chapter Antidepressant analgesics
Title of book Wall and Melzack's textbook of pain
Place of Publication Philadelphia, United States
Publisher Elsevier Saunders
Publication Year 2013
Sub-type Chapter in textbook
Open Access Status
Edition 6th
ISBN 9780702040597
9780702053740
Editor Stephen B. McMahon
Martin Koltzenberg
Irene Tracey
Dennis C. Turk
Chapter number 34
Start page 465
End page 496
Total pages 32
Total chapters 76
Collection year 2014
Language eng
Formatted Abstract/Summary
This chapter provides information on the pharmacology, guidelines, recent individual quality randomized controlled trials (RCTs), and data regarding efficacy and safety from recent systematic reviews involving antidepressants and pain. Of particular interest in these studies are the clinical meaningfulness of the results and how the drugs compare with the standard treatment of the more specific subclass of tricyclic antidepressants and other analgesics. An important concern is the limited external validity or generalizability of trial data on neuropathic pain to the same disorders in ordinary practice. The presence of negative RCTs of antidepressants for other painful states may suggest that the trial results are limited in this regard as well. The importance of comparative effectiveness research is raised. Head-to-head RCTs comparing different antidepressants and other analgesics for neuropathic pain are reviewed, and in their absence the value of indirect comparative measures such as the number needed to treat and to harm are discussed. Despite the increase in placebo-controlled RCTs of antidepressants for painful conditions, no striking advance or “magic bullet” for monotherapy has appeared. There continues to be a need for comparative effectiveness research on new antidepressants by quality RCTs that compare new and old drugs directly to guide clinical decision making. Because of deficiencies in this area and evidence of poor generalizability, combinations of the useful antidepressants with other analgesic drugs need to be considered.
Keyword Pain -- Treatment
Antidepressant analgesics
Q-Index Code B1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Book Chapter
Collections: Official 2014 Collection
School of Pharmacy Publications
 
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Created: Sat, 21 Dec 2013, 16:54:33 EST by Professor Maree Smith on behalf of School of Pharmacy