Guia Lumbalgia (cambios 8 feb).FH10 - Digemid

ComentariosLos antidepresivos tricíclicos o cuatricíclicos muestran un efecto analgésico a dosismenores que las necesarias para que alcancen su efecto antidepresivo. Ese efectoanalgésico se manifiesta por igual en pacientes deprimidos y no deprimidos.Padecen efectos secundarios aproximadamente un 20% de los pacientes tratados,aunque por motivos metodológicos es probable que este porcentaje infraestime laproporción real.Es desconocida la coste/efectividad de los antidepresivos en el tratamiento de lalumbalgia.Bibliografía1. Alcoff J, Jones E, Rust P, Newman R (1982) Controlled trial of imipramine for chronic low backpain. J Fam Pract, 14(5): 841-6.2. Ansari A (2000) The efficacy of newer antidepressants in the treatment of chronic pain: a reviewof current literature. Harv Rev Psychiatry, 7(5): 257-77.3. Atkinson JH, Slater MA, Wahlgren DR, Williams RA, Zisook S, Pruitt SD, Epping-Jordan JE,Patterson TL, Grant I, Abramson I, Garfin SR (1999) Effects of noradrenergic and serotonergicantidepressants on chronic low back pain intensity. Pain, 83(2): 137-45.4. Atkinson JH, Slater MA, Williams RA, Zisook S, Patterson TL, Grant I, Wahlgren DR, AbramsonI, Garfin SR (1998) A placebo-controlled randomized clinical trial of nortriptyline for chronic lowback pain. Pain, 76(3): 287-96.5. Dickens C, Jayson M, Sutton C, Creed F (2000) The relationship between pain and depressionin a trial using paroxetine in sufferers of chronic low back pain. Psychosomatics, 41(6): 490-9.6. Fishbain D (2000) Evidence-based data on pain relief with antidepressants. Ann Med, 32(5):305-16.7. Gardela G (1991) [Value of adjuvant treatment with imipramine for lumbosacral pain syndrome].Pol Tyg Lek, 46(30-31): 544-6.8. Goodkin K, Gullion CM, Agras WS (1990) A randomized, double-blind, placebo-controlled trialof trazodone hydrochloride in chronic low back pain syndrome. J Clin Psychopharmacol, 10(4):269-78.9. Hameroff SR, Cork RC, Scherer K, Crago BR, Neuman C, Womble JR, Davis TP (1982) Doxepineffects on chronic pain, depression and plasma opioids. J Clin Psychiatry, 43(8 Pt 2): 22-7.10.Hameroff SR, Weiss JL, Lerman JC, Cork RC, Watts KS, Crago BR, Neuman CP, Womble JR,Davis TP (1984) Doxepin's effects on chronic pain and depression: a controlled study. J ClinPsychiatry, 45(3 Pt 2): 47-53.11.Jenkins DG, Ebbutt AF, Evans CD (1976) Tofranil in the treatment of low back pain. J Int MedRes, 4(2 Suppl): 28-40.12.Pheasant H, Bursk A, Goldfarb J, Azen SP, Weiss JN, Borelli L (1983) Amitriptyline and chroniclow-back pain. A randomized double-blind crossover study. Spine, 8(5): 552-7.13.Salerno SM, Browning R, Jackson JL (2002) The effect of antidepressant treatment on chronicback pain: a meta-analysis. Arch Intern Med, 162(1): 19-24.14.Schreiber S, Vinokur S, Shavelzon V, Pick CG, Zahavi E, Shir Y (2001) A randomized trial offluoxetine versus amitriptyline in musculo-skeletal pain. Isr J Psychiatry Relat Sci, 38(2): 88-94.15.Staiger TO, Gaster B, Sullivan MD, Deyo RA (2003) Systematic review of antidepressants in thetreatment of chronic low back pain. Spine, 28(22): 2540-5.73 73