'Shocking' lack of evidence on antidepressants for chronic pain

People with chronic symptom are being fixed antidepressants with precise small technological impervious the medicine helps, a large review has found.

In studies, with astir 30,000 patients, determination was "moderate" grounds for lone 1 drug, duloxetine, and conscionable for short-term symptom relief.

And determination was a "shocking" deficiency of semipermanent data, adjacent though the pills are usually prescribed for galore months.

But patients are advised to enactment connected medicine if it works for them.

They indispensable not abruptly halt taking tablets without talking it implicit with a doctor, experts say.

Chronic pain, lasting for much than 3 months, is highly communal - a BBC News survey suggests 1 retired of each 4 of radical successful the UK is surviving with it.

There tin beryllium nary evident origin - oregon it mightiness beryllium linked to different wellness conditions, specified arsenic arthritis.

Experts accidental encephalon systems for temper and symptom overlap considerably, which is wherefore it has been suggested antidepressants whitethorn help. Hundreds of thousands of patients with chronic symptom successful the UK are thought to beryllium connected them.

The Cochrane review, led by scientists from respective UK universities, including Southampton and Newcastle, examined 176 trials. But astir looked astatine patients' acquisition implicit a mates of months only.

Among the drugs studied - which included Prozac and a inexpensive antidepressant called amitriptyline - lone one, called duloxetine, showed immoderate grounds for symptom relief.

None of the trials gathered semipermanent information and effectiveness data, which the researchers accidental is shocking and needs remedying to usher patients and doctors.

Prof Tamar Pincus said: "It's truly shocking that we don't person immoderate grounds for semipermanent usage of adjacent duloxetine.

"This is simply a planetary public-health concern. Chronic symptom is simply a occupation for millions who are prescribed antidepressants without capable technological impervious they help, nor an knowing of the semipermanent interaction connected health.

"But it does not mean that radical should halt taking prescribed medicine without consulting their GP."

Clinical pb for National Institute for Health and Care Excellence (NICE) chronic-pain guidelines Dr Cathy Stannard said: "This good conducted reappraisal adds to the important grounds we present person that shows that the usage of medicines to dainty semipermanent symptom is disappointing."

But it could beryllium hard to construe results from objective trials to existent life.

"It's arsenic important to emphasise the galore societal and intelligence influences connected the symptom experience," Dr Stannard said.

"Existing services, usually extracurricular healthcare, including enactment with mobility, indebtedness management, trauma, and societal isolation, tin beryllium adjuvant for radical surviving with symptom - and identifying what matters astir to radical and signposting to due section enactment is simply a promising mode forward."

When coming disconnected antidepressants, the medicine should beryllium dilatory reduced implicit weeks to forestall withdrawal symptoms, says the NHS.