Escitalopram 20 mg versus duloxetine 60 mg for the treatment of chronic low back pain.
BACKGROUND
Escitalopram has never been demonstrated to be useful in the treatment of chronic low back pain (CLBP), while duloxetine has demonstrated analgesic effect in chronic pain states. The aim of this trial was to examine the efficacy of escitalopram for the treatment of CLBP compared with duloxetine.


METHODS
A total of 85 adult patients with non-radicular CLBP entered a 13-week randomized study comparing escitalopram 20 mg with duloxetine 60 mg once daily. The primary measure was comparison of the two drugs on reduction in weekly mean 24-h average pain. Secondary measures included Clinical Global Impressions of Severity (CGI-S) and the 36-item Short-Form Health Survey (SF-36).


RESULTS
Eighty patients (n = 39 escitalopram, n = 41 duloxetine) completed the study. No significant differences existed between escitalopram and duloxetine on reduction in weekly mean 24-h average pain at end point. Both escitalopram and duloxetine demonstrated significant improvement on CGI-S and SF-36.


CONCLUSIONS
Escitalopram and duloxetine demonstrated efficacy and safety in the management of CLBP, with no significant differences. Results of this study should be replicated in a larger sample of patients.
Mazza
Marianna
M
Catholic University of Sacred Heart of Rome, Institute of Psychiatry and Psychology, Department of Neurosciences, Via Ugo De Carolis, 48, 00136 Rome, Italy. marianna.mazza@rm.unicatt.it
Mazza
Osvaldo
O
Pazzaglia
Costanza
C
Padua
Luca
L
Mazza
Salvatore
S
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use; D000068736:Duloxetine Hydrochloride; D005260:Female; D006306:Health Surveys; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D015283:Citalopram; D000068736:Duloxetine Hydrochloride; D017367:Selective Serotonin Reuptake Inhibitors; D013876:Thiophenes