Researchers find anti-depressants reduce pain in opioid-dependent patients

November 3, 2011

In what is believed to be the first study of its kind to demonstrate an association between the antidepressant escitalopram and improved general pain, researchers from Boston University School of Medicine (BUSM), have found that opioid-dependent patients treated with escitalopram experienced meaningful reductions in pain severity and pain interference during the first three months of therapy. These findings appear in the journal Pain.

Pain is common in opioid-dependent patients yet pharmacologic strategies are limited. Among methadone-treated patients, estimates of chronic pain prevalence range between 37-61 percent. Management of pain in opioid-dependent patients is a clinical challenge given concerns for opioid abuse and misuse among individuals with prior substance use disorders. Yet unresolved pain may be a risk factor for relapse among patients whose pain is not fully treated.

According to the authors antidepressants may constitute an appealing option for treating pain in opioid-dependent patients because of the frequent coexistence of depression in this population. The use of (SSRIs) for chronic pain conditions has been less well studied.

The study used from a randomized, controlled trial that evaluated the effects of escitalopram on treatment retention in patients with who were initiating / for treatment of opioid dependence. Participants were randomized to receive 10 m.g. of escitalopram or a placebo daily. Changes in pain severity, pain interference and depression were assessed at one, two and three-month visits with the visual analog scale, Brief Pain Inventory, and the II, respectively.

"This study found that treatment with escitalopram resulted in significantly decreased pain severity and interference over time, with a nearly 30 percent reduction in pain severity after one month compared to control," explained lead author Judith Tsui, MD, MPH, assistant professor of medicine at BUSM. "Adjusting for within-subject changes in depression scores did not affect the effects of escitalopram, suggesting the analgesic properties of escitalopram were independent of its antidepressant effects," she said.

Tsui stresses that more research is needed on the use of nonnarcotic medications such as SSRIs to treat pain in opioid-dependent populations. "Alternative, non-opioid pharmacologic therapies are needed to address pain in opioid-dependent populations."

Related Stories

Recommended for you

Artificial beta cells

December 8, 2016

Researchers led by ETH Professor Martin Fussenegger at the Department of Biosystems Science and Engineering (D-BSSE) in Basel have produced artificial beta cells using a straightforward engineering approach.

Key regulator of bone development identified

December 8, 2016

Loss of a key protein leads to defects in skeletal development including reduced bone density and a shortening of the fingers and toes—a condition known as brachydactyly. The discovery was made by researchers at Penn State ...

Researchers question lifelong immunity to toxoplasmosis

December 8, 2016

Medical students are taught that once infected with Toxoplasma gondii—the "cat parasite"—then you're protected from reinfection for the rest of your life. This dogma should be questioned, argue researchers in an Opinion ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.