A new study has found that antidepressants could be an effective option in easing painful conditions like osteoarthritis with fewer side-effects than the traditionally prescribed drugs like anti-inflammatories and opioids.
Leslie Citrome, professor of psychiatry and behavioural sciences and Amy Weiss-Citrome from New York Medical College, analysed the latest clinical evidence on duloxetine, an antidepressant approved by the FDA for use in chronic musculoskeletal pain, including osteoarthritis.
"It is not uncommon to treat osteoarthritis with a combination of drugs that work in different ways," explained Citrome, the International Journal of Clinical Practice reported.
The authors looked at studies exploring the effects of duloxetine being used on its own or in combination with non-steroidal anti-inflammatory drugs (NSAIDs).
NSAIDs are used to treat inflammation, mild to moderate pain, and fever. Specific uses include the treatment of headaches, arthritis, sports injuries, and menstrual cramps.
These included the two randomised double-blind, placebo controlled clinical trials that formed the basis of FDA approval for duloxetine for the treatment of chronic pain linked with osteoarthritis.
When the side-effects of the various drugs were taken into account, this showed that when duloxetine was used on its own for 13 weeks it provided a number of advantages over NSAIDs, which can lead to gastrointestinal bleeding, and opiates (pain killers) such as morphine, which can cause constipation.
The most common side effects of duloxetine - nausea, fatigue and constipation - were small when compared to the placebo. The studies used to gain FDA approval also showed that pain reduction using duloxetine on its own was not dependent on an improvement in depressive symptoms.