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Evidence summaries

Antidepressants for Psychogenic Pain and Somatoform Pain Disorder

Antidepressants appear to be effective for psychogenic pain and somatoform pain disorder. Level of evidence: "B"

A systematic review 1 including 11 studies (7 placebo-controlled double-blind RCTs and 4 placebo-controlled double-blind cross-over trials) with a total of 832 subjects was abstracted in DARE. The combined difference showed that antidepressants decreased pain intensity significantly more than placebo (z=05.71). The overall mean effect size was 0.48, and ranged from 0 to 0.91. The fail-safe N was 133. The combined effect size for headache pain was greater than that for mixed pain.

Comment: The quality of evidence is downgraded by study limitations.

    References

    • Fishbain DA, Cutler RB, Rosomoff HL, Rosomoff RS. Do antidepressants have an analgesic effect in psychogenic pain and somatoform pain disorder? A meta-analysis. Psychosom Med 1998 Jul-Aug;60(4):503-9. [PubMed] [DARE]

Primary/Secondary Keywords