ReviewCurrent pain and headache reports2019
Off-label Antidepressant Use for Treatment and Management of Chronic Pain: Evolving Understanding and Comprehensive Review.
Review in Current pain and headache reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Antidepressants for low back pain and spine-related leg pain.The Cochrane database of systematic reviews · 2025Pooled it
- Prediction and diagnosis of depression using machine learning with electronic health records data: a systematic review.BMC medical informatics and decision making · 2023Pooled it
- The Effect of Neuromodulatory Drugs on the Intensity of Chronic Pelvic Pain in Women: A Systematic Review.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2022Pooled it
- Endocannabinoid system modulation in acute, chronic, and neuropathic pain: reviewing experimental models, clinical evidence, and nanotechnology delivery.Metabolic brain disease · 2026Review
- Evaluation of Antidepressant Effects of Zhuyeqing Liquor UsingFood science & nutrition · 2025Article
- Cytotoxic Effect of Escitalopram/Etoposide Combination on Etoposide-Resistant Lung Cancer.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Pharmaceuticals and personal care products in Canadian municipal wastewater and biosolids: occurrence, fate, and time trends 2010-2013 to 2022.Environmental science and pollution research international · 2025Article
- UK medical cannabis registry: A clinical outcome analysis of medical cannabis therapy in chronic pain patients with and without co-morbid sleep impairment.Pain practice : the official journal of World Institute of Pain · 2025Article
- Pain Management in Fibromyalgia: Evaluating the Roles of Pregabalin, Duloxetine, and Milnacipran.Cureus · 2024Article
- Review
- Replicability and reproducibility of predictive models for diagnosis of depression among young adults using Electronic Health Records.Diagnostic and prognostic research · 2023Article
- Are psychedelic medicines the reset for chronic pain? Preliminary findings and research needs.Neuropharmacology · 2023Review
- Microglia cause structural remodeling of noradrenergic axon in the trigeminal spinal subnucleus caudalis after infraorbital nerve injury in rats.Brain, behavior, & immunity - health · 2023Article
- Assessment of clinical outcomes in patients with fibromyalgia: Analysis from the UK Medical Cannabis Registry.Brain and behavior · 2023Article
- [Adverse effects of opioids, antidepressants and anticonvulsants on sex hormones : Often unnoticed but clinically relevant].Schmerz (Berlin, Germany) · 2022Article
- Depression and Pain: Use of Antidepressants.Current neuropharmacology · 2022Review
- A Look at Commonly Utilized Serotonin Noradrenaline Reuptake Inhibitors (SNRIs) in Chronic Pain.Health psychology research · 2022Article
- Anesthetic Considerations for Patients on Psychotropic Drug Therapies.Neurology international · 2021Review
- Occipital Neuralgia.Current pain and headache reports · 2021Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purpose of reviewWhile clinicians have been using antidepressants for off-label indications in the treatment of chronic pain in recent years, newer studies have proven effectiveness and provided additional mechanistic understanding and defined potential adverse effects. As depression and chronic pain are frequently comorbid conditions, the use of antidepressants has allowed for treatment of both conditions concomitantly in the same patient population. RECENT
findingsThe most commonly used antidepressants for chronic pain are tricyclic antidepressants (TCAs), though selective serotonin or noradrenaline reuptake inhibitors and other atypical antidepressants have been shown to be effective at treating chronic pain. In addition to neuropathic pain, bupropion has also demonstrated effectiveness in treating chronic pain caused by inflammatory bowel disease. Selective norepinephrine receptor inhibitors (SNRIs), including duloxetine, serve to suppress neuropathic pain by altering recovery of the noradrenergic descending inhibitory system in the spinal cord. While the direct mechanism of action is largely unknown, TCAs may suppress the noradrenergic descending inhibitory system to produce an antihyperalgesic effect. The use of antidepressants offers alternative and adjunctive therapy options for patients suffering from chronic pain from various modalities. TCAs, mono-amine oxidase inhibitors, selective serotonin receptor inhibitors, SNRIs, and atypical antidepressants have been shown to have analgesic and sometimes antiinflammatory capabilities that are independent of their mood-stabilizing effects. Further studies are warranted to establish better safety profiles and efficacy of antidepressant use in chronic pain.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.