Posted on 05/10/2023 10:35:08 AM PDT by ConservativeMind
Most antidepressants used for chronic pain are being prescribed with "insufficient" evidence of their effectiveness, scientists have warned.
A major investigation into medications used to manage long-term pain has found that harms of many of the commonly recommended drugs have not been well studied.
Among the drugs studied were amitriptyline, fluoxetine, citalopram, paroxetine, sertraline, and duloxetine—with only the latter showing reliable evidence for pain relief.
Professor Tamar Pincus said, "This is a global public health concern. Chronic pain is a problem for millions who are prescribed antidepressants without 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. 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."
The two-year Cochrane study was the largest-ever assessment of antidepressants recommended by leading bodies including the UK's National Institute for Health and Care Excellence (NICE) and the Food and Drug Administration (FDA) in the U.S..
Statistician Gavin Stewart said "We are calling on governing health bodies NICE and the FDA to update their guidelines to reflect the new scientific evidence, and on funders to stop supporting small and flawed trials. Evidence synthesis is often complex and nuanced, but the evidence underpinning the use of these treatments is not equivalent, so current treatment modalities are hard to justify."
The review revealed that duloxetine was consistently the highest-rated medication and was equally as effective for fibromyalgia, musculoskeletal, and neuropathic pain conditions.
Standard doses of duloxetine are as successful for reducing pain as higher quantities
"The only reliable evidence is for duloxetine."
(Excerpt) Read more at medicalxpress.com ...
I told him that, then asked him it it was simply possible the doctor just wanted him to be happy from the pain.
I guess I was ahead of Cochrane, again.
I've had 4 major lower back surgeries and suffer peripheral neuropathy in both legs below my knees as a result.
Been taking 60mg duloxetine once a day @ bedtime for years. It absolutely helps me.
bkmk
...lack reliable evidence of efficacy or safety, ....
That never stopped them before!.....................
I take a 10mg amitriptyline tablet right before bed per my ENT to help alleviate nerve damage caused by Covid-19. I honestly don’t know if it has helped, though the nerve damage has definitely been healing, thanks be to God.
Bookmark
There’s not much evidence that they help with depression either. However they are great if you can to create a population of mass shooters. Or mothers who drown their own children. Then antidepressants are just the ticket
Took amitriptyline for nerve pain / low back pain for years and it was a great help. It also was great for sleep as well. First read about it in a book called the healthy back bible as I didn’t want surgery and two surgeons even said my situation was maybe 50/50 for success if I went through with back fusion surgery. Over the 15 or so years went from 20mg to 100mg and only recently stopped taking it to evaluate current situation. When I first started it, after about three weeks I could certainly feel improvement. YMMV.
Ping
“Most antidepressants used for chronic pain …”
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Lunacy. No credibility.
The duloxetine/Cymbalta has to be tapered up slowly to the effective pain relief level. Nausea is horrendous. 120mg a day took me over a month to get there. Also it works better if you can throw 60mg a day of muscle relaxer baclofen (also needs to be tapered up) and it does have a analgesic effect. Enough so that I was able to finally detox from years of prescribed opioid use. That alone relieves a ton of pain from your body. YES ~ Opioids cause PAIN!
Its all off label prescribing by a valid VA doc with at least 3 reviews. Beats the hell out of the years of off label legally prescribed opioids and Benzos my sadistic doctor had me on, so take your pic.
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And yes, I give them a very hard time about the off label prescribing/use and how Ivermectin is used off label to help with COVID. Man, you think the stuff is radioactive-poison the way some doctors act. I give them both barrels.
The Death and Resurrection of Science
But what really made my hair stand on end was this bit on the author at the end...
...Dr. Peter Gøtzsche co-founded the Cochrane Collaboration, once considered the world’s preeminent independent medical research organization... Following many years of being an outspoken critic of the corruption of science by pharmaceutical companies, Gøtzsche’s membership on the governing board of Cochrane was terminated by its Board of Trustees in September, 2018. Four board resigned in protest...
Cochrane is lost.
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