Treating the physical symptoms of depression with second-generation antidepressants: a systematic review and metaanalysis.
BACKGROUND
Approximately two-thirds of patients with depression experience physical pain symptoms. Coexisting pain complicates the treatment of depression and is associated with worse depression outcomes.


OBJECTIVE
The authors reviewed the effect of newer antidepressants on pain in patients with depression.


METHODS
The authors searched systematically for trials of second-generation antidepressants that enrolled depression patients and reported pain outcomes, pooling changes on the pain visual-analog scale (VAS), using random-effects models.


RESULTS
Eight trials were eligible. Pooled analysis of head-to-head trials showed no difference in VAS between duloxetine and paroxetine. Both drugs were superior to placebo.


CONCLUSIONS
The authors found insufficient evidence to support the choice of one second-generation antidepressant over another in patients with pain accompanying depression.
Krebs
Erin E
EE
Center on Implementing Evidence-Based Practice, Roudebush Veterans Affairs Medical Center, Indianapolis, IN 46202, USA. krebse@iupui.edu
Gaynes
Bradley N
BN
Gartlehner
Gerald
G
Hansen
Richard A
RA
Thieda
Patricia
P
Morgan
Laura C
LC
DeVeaugh-Geiss
Angela
A
Lohr
Kathleen N
KN
D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D000068736:Duloxetine Hydrochloride; D006304:Health Status; D006801:Humans; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology*; D010147:Pain Measurement; D017374:Paroxetine / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*
D018687:Antidepressive Agents, Second-Generation; D013876:Thiophenes; D017374:Paroxetine; D000068736:Duloxetine Hydrochloride