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J Gen Intern Med. Jun 1997; 12(6): 384–389.
PMCID: PMC1497123
The Efficacy of Selective Serotonin Reuptake Inhibitors for the Management of Chronic Pain
Alan C Jung, MD,1 Thomas Staiger, MD,1 and Mark Sullivan, MD, PhD2
1Received from the Department of Medicine, University of Washington, Seattle
2The Department of Psychiatry, Multidisciplinary Pain Center, University of Washington, Seattle
Address correspondence and reprint requests to Dr. Jung: Department of Medicine Residency Office, P.O. Box 356421, University of Washington, Seattle, WA 98195.
Abstract
OBJECTIVE
To assess the effectiveness of selective serotonin reuptake inhibitors (SSRIs) in the management of chronic pain.
METHODS
Randomized, controlled trials of SSRIs in the management of chronic pain were identified by searching MEDLINE from 1966 to 1997 and by contacting the manufacturers of SSRIs available in the United States.
MAIN RESULTS
Nineteen studies were identified, including 10 on the treatment of headache, 3 on diabetic neuropathy, 3 on fibromyalgia, and 3 on mixed-chronic pain. SSRIs were consistently helpful for mixed-chronic pain. Results were conflicting for migraine headache, tension headache, diabetic neuropathy, and fibromyalgia.
CONCLUSIONS
SSRIs appear to be beneficial for mixed-chronic pain. It is unclear, from the available evidence, whether SSRIs are beneficial for migraine headaches, tension headaches, diabetic neuropathy, or fibromyalgia. For those patients it may be reasonable to reserve SSRIs for those who fail to respond to other medications or who are intolerant of their side effects.
Keywords: chronic pain, management of, selective serotonin reuptake inhibitors
Articles from Journal of General Internal Medicine are provided here courtesy of
Society of General Internal Medicine