Patients are instructed to consult their physicians if they have any concerns and not to stop taking medications already prescribed.
Wednesday 10 May 2023 04:22, United Kingdom
Hundreds of thousands of Britons take antidepressants for chronic pain, according to large studies, but there is not enough evidence.
The researchers looked at drugs commonly prescribed by the NHS, including amitriptyline, duloxetine, fluoxetine (Prozac), citalopram, paroxetine (Serozat) and sertraline.
They concluded that only duloxetine has strong evidence of pain relief.
The National Institute for Health and Care Excellence (Nice) recommends them as an option when the underlying cause is unknown, such as cancer pain and conditions that can cause neuropathic pain, such as stroke. I’m here.
It said it had reviewed the study in detail, but determined that an update to the guidelines was not currently necessary.
The study looked at 176 trials and about 30,000 patients and included institutions such as University College London and the Universities of Bath, Bristol and Southampton.
Concerns were also raised about the lack of long-term data on drug safety.
Lead author Professor Tamar Pincus said the findings had raised “global public health concerns”, adding that “without sufficient scientific evidence or understanding of long-term health effects, “There are people who prescribe drugs,” he said.
“Our review found no reliable evidence of the long-term efficacy of antidepressants, and no reliable evidence of their safety in chronic pain.
“While we found that duloxetine provided short-term analgesic benefits in the patients studied, we remain concerned about its potential for long-term harm due to gaps in the current evidence.”
Read more on Sky News
Britain’s first ‘three-parent baby’ born after IVF procedure
COVID is no longer a health emergency, says WHO
Professor Pincus said about 15 million low-dose amitriptyline prescriptions will be prescribed in the UK in 2020-21, with hundreds of thousands likely taking it for pain, but that the drug is “probably not very healthy. It’s not the target.”
“The fact that you can’t find evidence that it works is not the same as finding evidence that it doesn’t work.
“We don’t know. The research just isn’t good enough, and we don’t know if it will do any harm either.”
Patients ‘don’t panic’
The authors urge people to continue on their prescribed medications and raise concerns with their GP.
Dr Ryan Patel of King’s College London explained that antidepressants are prescribed for pain because “the systems regulating mood and pain overlap considerably”.
He argued that the study was based on the idea that “if clinical trials are poorly designed under the assumption that everyone’s experience of pain is the same, most antidepressants will be limited to treating chronic pain.” It appears that it has only limited uses,” he said.
The chairman of the Royal College of GPs said doctors aim to treat chronic pain with a combination of psychological, pharmacological and physical treatments, prescribing “the least amount of medicine in the shortest amount of time”. I was.
Professor Camilla Hawthorne said patients “shouldn’t panic” and reiterated that medication should be continued until discussed with their primary care physician.
Nice says that recommending antidepressants as a treatment option is the result of a thorough consideration of the benefits and harms.
Evidence has shown that it can reduce “quality of life, pain, sleep, and emotional distress, even without a diagnosis of depression.”
