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Research identifies role of antidepressants in relief of chronic osteoarthritis pain

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The antidepressant duloxetine has shown good results in relieving the chronic pain of osteoarthritis in FDA-approval trials, according to a recent perspective paper in the International Journal of Clinical Practice.

In examining studies that involving duloxetine, an antidepressant drug approved by the FDA in 2010 to treat chronic musculoskeletal pain associated with osteoarthritis (OA), the researchers learned it has a low number needed to treat, indicating it is an advantageous treatment approach, according to the abstract. These data were compared with the number needed to harm over two FDA-approved studies, for which a low number indicates greater disadvantages of a therapy.

Of note in the two studies used to gain FDA approval for duloxetine was that its ability to reduce chronic pain did not depend on an improvement depressive symptoms, according to a press release from the journal.

“It is not uncommon to treat osteoarthritis with a combination of drugs that work in different ways,” Leslie Citrome, MD, MPH, clinical professor of psychiatry and behavioral sciences at New York Medical College, Valhalla, N.Y., stated in the release. “Our review supports this approach and confirms that antidepressants are not just for depression and can play a key role in relieving this painful condition.”

Another study analyzed by Citrome and colleague Amy Weiss-Citrome, MD, a physical medicine and rehabilitation specialist, concluded a combination of duloxetine and NSAIDs resulted in greater reduction of pain in patients with knee OA than when they took the NSAIDs with a placebo.

“We believe that our analysis of these studies demonstrate that clinicians managing patients suffering from OA should also consider prescribing adjunctive antidepressants that can effectively impact on central pain pathways,” Citrome stated in the release.

Reference:

• Citrome L, Weiss-Citrome A. Antidepressants and the relief of osteoarthritic pain – Findings from a study examining adjunctive duloxetine. Int J Clin Pract. Published online before print March, 2012. doi:10.1111/j.1742-1241.2012.02899.x