No clear evidence that antidepressants assist in the management of chronic low back pain

Doctors commonly prescribe antidepressants for patients with low back pain for three main reasons; to relieve pain; reduce mild depression and improve a person's mood; and improve sleep.

Despite this, the use of antidepressants in low back pain is controversial with different studies arriving at different conclusions.

A team of Cochrane Researchers therefore set out to search for high quality evidence and use this to assess the effectiveness of antidepressants for the management of low back pain.

The review identified 10 trials that compared antidepressant treatment with placebo.

“We found no clear evidence to support the clinician's prescription of antidepressants in reducing pain and depression for patients with chronic low back pain,” says lead author Dr Donna Urquhart who works in the Department of Epidemiology and Preventive Medicine at Monash University, Melbourne, Australia.

However, this does not mean that patients with significant depression should avoid antidepressants, as they play an important role in the treatment of clinical depression.

In addition, the review cautions that there is a need for larger and more sophisticated studies to confirm the conclusions.