Antidepressants are commonly used to treat low back pain and spine‐related leg pain. However, their benefits and harms are uncertain.
The Cochrane review included 26 randomised controlled trials. Eighteen studies included 2535 participants with non‐specific low back pain, seven studies included 329 participants with spine‐related leg pain, and one study included 68 participants with either condition. Most participants had pain lasting more than three months.
In people with non‐specific low back pain, SNRIs probably have small effects on pain intensity, trivial effects on disability, and are probably associated with adverse effects. TCAs probably do not reduce low back pain intensity, but may have a small effect on disability. The effects of antidepressants on spine‐related leg pain are uncertain, though SNRIs and TCAs might be prioritised over other classes for future investigations.
Evidence for the safety of SSRIs, TCAs, TeCAs, and other antidepressants in non‐specific low back pain and spine‐related leg pain remains unclear.
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