title: Antidepressant drugs for chronic urological pelvic pain: an evidence-based review.
abstract: The use of antidepressant drugs for the management of chronic pelvic pain has been supported in the past. This study aimed to evaluate the available evidence for the efficacy and acceptability of antidepressant drugs in the management of urological chronic pelvic pain. Studies were selected through a comprehensive literature search. We included all types of study designs due to the limited evidence. Studies were classified into levels of evidence according to their design. Ten studies were included with a total of 360 patients. Amitriptyline, sertraline, duloxetine, nortriptyline, and citalopram are the antidepressants that have been reported in the literature. Only four randomized controlled trials (RCTs) were identified (two for amitriptyline and two for sertraline) with mixed results. We conclude that the use of antidepressants for the management of chronic urological pelvic pain is not adequately supported by methodologically sound RCTs. From the existing studies amitriptyline may be effective in interstitial cystitis but publication bias should be considered as an alternative explanation. All drugs were generally well tolerated with no serious events reported.
authors.affiliation: Postgraduate Program in the Management of Pain, University of Ioannina School of Medicine, Greece. cpapas@otenet.gr
authors.forename: Christos
authors.initials: C
authors.lastname: Papandreou
authors.forename: Petros
authors.initials: P
authors.lastname: Skapinakis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Giannakis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Sofikitis
authors.forename: Venetsanos
authors.initials: V
authors.lastname: Mavreas