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Text
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<a href="http://doi.org/10.1093/rheumatology/ken110" target="_blank" rel="noreferrer">http://doi.org/10.1093/rheumatology/ken110</a>
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Title
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Is there any evidence to support the use of anti-depressants in painful rheumatological conditions? Systematic review of pharmacological and clinical studies
Publisher
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Rheumatology
Date
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2008
Subject
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Humans; Evidence-Based Medicine; Randomized Controlled Trials as Topic; Chronic disease; Pain/drug therapy/etiology; Fibromyalgia/drug therapy; Antidepressive Agents/therapeutic use; Arthritis/complications/drug therapy; Low Back Pain/drug therapy; Rheumatic Diseases/complications/drug therapy
Creator
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Perrot S; Javier RM; Marty M; Le Jeunne C; Laroche F; CEDR (Cercle d'Etude de la Douleur en Rhumatologie France) Pain Study Section French Rheumatological Society
Description
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The aim of this study was to review the evidence supporting the use of anti-depressants in painful rheumatological conditions. A systematic review of papers published between 1966 and 2007, in five European languages, on anti-depressants in rheumatological conditions was performed. Papers were scored using Jadad method and analgesic ES was calculated. We selected 78 clinical studies and 12 meta-analyses, from 140 papers. The strongest evidence of an analgesic effect of anti-depressants has been obtained for fibromyalgia. A weak analgesic effect is observed for chronic low back pain, with an efficacy level close to that of analgesics. In RA and AS, there is no analgesic effect of anti-depressants, but these drugs may help to manage fatigue and sleep disorders. There is no clear evidence of an analgesic effect inOA, but studies have poor methodological quality. Analgesic effects of anti-depressants are independent of their anti-depressant effects. Tricyclic anti-depressants (TCAs), even at low doses, have analgesic effects equivalent to those of serotonin and noradrenalin reuptake inhibitors (SNRIs), but are less well tolerated. Selective serotonin reuptake inhibitors (SSRIs) have modest analgesic effects, but higher doses are required to achieve analgesia. Anti-depressant drugs, particularly TCAs and SNRIs, have analgesic effects in chronic rheumatic painful states in which analgesics and NSAIDs are not very efficient, such as fibromyalgia and chronic low back pain. In inflammatory rheumatic diseases, anti-depressants may be useful for managing fatigue and sleep disorders. Further studies are required to compare anti-depressants with other analgesics in the management of chronic painful rheumatological conditions.
2008
Identifier
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<a href="http://doi.org/10.1093/rheumatology/ken110" target="_blank" rel="noreferrer">10.1093/rheumatology/ken110</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2008
Antidepressive Agents/therapeutic use
Arthritis/complications/drug therapy
Backlog
CEDR (Cercle d'Etude de la Douleur en Rhumatologie France) Pain Study Section French Rheumatological Society
Chronic Disease
Evidence-based Medicine
Fibromyalgia/drug therapy
Humans
Javier RM
Journal Article
Laroche F
Le Jeunne C
Low Back Pain/drug therapy
Marty M
Pain/drug therapy/etiology
Perrot S
Randomized Controlled Trials as Topic
Rheumatic Diseases/complications/drug therapy
Rheumatology