Antidepressants worthless for low back pain

Antidepressants might be worthless for treating low back pain, suggests a new review that found no evidence to support using the drugs in this way. Yet, up to 23 percent of U.S. physicians report prescribing antidepressants to patients with low back pain.

"The prescription of antidepressants as a treatment for back pain remains controversial," Donna Urquhart, PhD, research fellow at Monash University in Melbourne, Australia, and lead review author.

The review appears in the The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research.

Physicians commonly prescribe antidepressants for patients with low back pain to provide pain relief, aid in sleep and treat coexisting depression.

For the review, Urquhart and colleagues analyzed 10 published studies that compared antidepressants to placebos in patients with low back pain. The studies included patients with problems such as ruptured discs, slipped vertebrae and pain due to pinched nerves

"The review found no convincing evidence that antidepressants relieve back pain or depression more effectively than placebo," Urquhart said. Nor did researchers find any difference in patients' ability to function, whether receiving antidepressants or placebo.

Urquhart concluded that "... existing studies do not provide adequate evidence for or against the use of antidepressants in low back pain and further research is needed. In the meantime, antidepressants should be regarded as an unproven treatment for nonspecific low back pain."

SOURCE: "Antidepressants for non-specific low back pain" by Donna M. Urquhart, et al. Cochrane Database of Systematic Reviews, 2008, Issue 1.