Hundreds of hundreds of Britons are taking antidepressants for power ache with out sufficient proof they work, in response to a big examine.
Researchers checked out medicine generally prescribed by the NHS together with amitriptyline, duloxetine, fluoxetine (Prozac), citalopram, paroxetine (Seroxat) and sertraline.
They concluded solely duloxetine had sturdy proof for ache reduction.
The National Institute for Health and Care Excellence (Nice) recommends them as an choice the place the basis trigger is unknown, together with for some most cancers ache, and situations that may trigger neuropathic ache, akin to stroke.
It stated it had reviewed the examine intimately however determined an replace to tips was presently pointless.
The analysis checked out 176 trials and nearly 30,000 sufferers, and included establishments akin to University College London, and the schools of Bath, Bristol and Southampton.
It additionally raised issues a couple of lack of long-term information on the medicine’ security.
Lead creator Professor Tamar Pincus stated the findings raised a “global public health concern”, with folks prescribed the medicine with out “sufficient scientific proof they help, nor an understanding of the long-term impact on health”.
“Our review found no reliable evidence for the long-term efficacy of any antidepressant, and no reliable evidence for their safety for chronic pain at any point,” she stated.
“Though we did find that duloxetine provided short-term pain relief for patients we studied, we remain concerned about its possible long-term harm due to the gaps in current evidence.”
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Professor Pincus stated there have been round 15 million low-dose amitriptyline prescriptions in England in 2020 to 2021 – and a whole bunch of hundreds probably taking it for ache – however the drug is “probably not very healthy”.
“The fact that we don’t find evidence whether it works or not is not the same as finding evidence that it doesn’t work,” she added.
“We don’t know – the studies simply are not good enough and, similarly, we don’t know whether it harms or not.”
Patients ‘should not panic’
The authors are urging folks to proceed medicine they’ve been prescribed and to lift any issues with their GP.
Dr Ryan Patel, from King’s College London, defined that antidepressants are prescribed for ache as a result of “the systems that regulate mood and pain overlap considerably”.
He stated the examine confirmed “when clinical trials are designed poorly under the assumption that everyone’s experience of pain is uniform, most antidepressants appear to have limited use for treating chronic pain”.
The chair of the Royal College of GPs stated docs goal to deal with power ache with a mixture of psychological, pharmacological and bodily therapies – and to prescribe “the lowest dose of medicines, for the shortest time”.
Professor Kamila Hawthorne stated sufferers “shouldn’t panic” and reiterated they need to proceed with their medicine till they’ve mentioned issues with their GP.
Nice stated its advice for antidepressants as a therapy choice got here after a radical take a look at the advantages and harms.
It stated proof confirmed they may also help with “quality of life, pain, sleep and psychological distress, even in the absence of a diagnosis of depression”.
Source: information.sky.com”
