Osteoarthritis and back pain are one of the leading causes of disabilities. Antidepressants have been used across the world to suppress pain, but their efficacy is not well studied. This study aims to examine the safety and efficacy of antidepressants for osteoarthritis and back pain.

This systematic review and meta-analysis included randomized control trials comparing the safety and efficacy of antidepressant drugs with placebo for pain related to osteoarthritis and back pain. The primary outcomes of the study were pain and disability. The secondary outcome was safety, and the risk of bias was analyzed using Cochrane Collaboration’s tool and GRADE framework.

A total of 33 trials involving 5,318 participants were included. Moderate certainty evidence suggested that serotonin-noradrenaline reuptake inhibitors (SNRIs) reduced back pain, whereas low certainty evidence showed that SNRIs reduced osteoarthritis pain. Very low certainty evidence showed that SNRIs reduced sciatica, and low to very low certainty evidence showed that TCAs did not reduce sciatica. Moderate certainty evidence also showed that SNRIs reduced disability from back pain and osteoarthritis.

The research concluded that moderate certainty evidence suggested that SNRIs reduced the incidence of pain and disability in patients suffering from back pain or osteoarthritis.

Ref: https://www.bmj.com/content/372/bmj.m4825