Antidepressants for neuropathic pain: a Cochrane review

For many years antidepressant drugs have been used to manage neuropathic pain, and are often the first choice treatment. It is not clear, however, which antidepressant is more effective, what role the newer antidepressants can play in treating neuropathic pain and what adverse effects are experienced by patients. To determine the analgesic effectiveness and safety of antidepressant drugs in neuropathic pain, a systematic review of randomised controlled trials reporting the analgesic effects of antidepressant drugs in adult patients, with subjective assessment of pain of neuropathic origin, was performed. Studies that included patients with chronic headache and migraine were excluded. Randomised trials of antidepressants in neuropathic pain were identified in MEDLINE (1966–Oct 2005), EMBASE (1980–Oct 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library 2005, Issue 3 and the Cochrane Pain, Palliative and Supportive …