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Antidepressants for neuropathic pain: a Cochrane review
  1. Tiina Saarto1,
  2. Phil J Wiffen2
  1. 1Helsinki University Central Hospital, Department of Oncology, Helsinki, Finland
  2. 2Cochrane Pain, Palliative and Supportive Care Group, UK
  1. Correspondence to Dr T Saarto, Helsinki University Central Hospital, Department of Oncology, PO Box 180, FIN-00029 HUS, Helsinki, Finland; tiina.saarto{at}

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For many years antidepressant drugs have been used to manage neuropathic pain, and are often the first choice treatment. It is not clear, however, which antidepressant is more effective, what role the newer antidepressants can play in treating neuropathic pain and what adverse effects are experienced by patients.


To determine the analgesic effectiveness and safety of antidepressant drugs in neuropathic pain, a systematic review of randomised controlled trials reporting the analgesic effects of antidepressant drugs in adult patients, with subjective assessment of pain of neuropathic origin, was performed. Studies that included patients with chronic headache and migraine were excluded. Randomised trials of antidepressants in neuropathic pain were identified in MEDLINE (1966–Oct 2005), EMBASE (1980–Oct 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library 2005, Issue 3 and the Cochrane Pain, Palliative and Supportive …

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  • This paper is based on a Cochrane Review published in full in the Cochrane Library: Saarto T,Wiffen PJ. Antidepressants for neuropathic pain. Cochrane Database Syst Rev 2008; 1:CD005454. Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and The Cochrane Library should be consulted for the most recent version of the review (see for information).

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.