Pain

Which antidepressants are best for treating chronic pain?

In the journals

By , Executive Editor, Harvard Men's Health Watch

Photo of a woman at the doctor asking for a prescription.

Antidepressants are sometimes prescribed for chronic pain conditions even in people who do not have depression. But are these medications equally effective? A study published online Feb. 1, 2023, by The BMJ suggests not.

Antidepressants are thought to help by acting on chemicals in the brain that assist with pain relief, such as serotonin. Here, researchers looked at 156 trials involving more than 25,000 people that compared antidepressant with placebo treatment for any pain condition. Although most antidepressants prescribed for pain treatment are tricyclic antidepressants (amitriptyline is the most commonly used for pain) the evidence was unclear on how well these drugs work or whether they help treat most pain conditions. In comparison, antidepressants known as serotonin-norepinephrine reuptake inhibitors (SNRIs) — particularly duloxetine (Cymbalta) — were found to be the most effective, and proved useful for the largest number of pain conditions, including back pain, knee osteoarthritis, postoperative pain, fibromyalgia, and nerve pain.

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About the Author

photo of Matthew Solan

Matthew Solan, Executive Editor, Harvard Men's Health Watch

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s … See Full Bio
View all posts by Matthew Solan

About the Reviewer

photo of Howard E. LeWine, MD

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio
View all posts by Howard E. LeWine, MD

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