Effectiveness of antidepressants in neuropathic pain management: a retrospective, multicenter cross-sectional analysis

Neuropathic pain (NP) arises as a direct consequence of a lesion or disease affecting the somatosensory nervous system. Antidepressants (ADs) are recommended for the pharmacological treatment of NP. However, current guidelines do not specify how long ADs may be effective in NP treatment if the patient is benefiting from the therapy. This was a retrospective cross-sectional study aiming to analyze the effectiveness of ADs in the treatment of NP by assessing the relationship between AD usage, the length of AD treatment and the intensity of pain in this group patients. Based on their pain intensity and length of treatment, the patients were divided into: three groups (NRS 0-3, NRS 4-6 and NRS ≥ 7), and six groups (< 1 month, 1-3 months, 3-6 months, 6-12 months, 1-2 years, 2-5 years, and > 5 years), respectively. The study was conducted on a database from 421 patients, 231 (54.86%) of whom took antidepressants. We found that AD treatment significantly reduces the likelihood of being in the NRS 7-10 group compared to the NRS 0-3 group (OR = 0.611, 95% CI: 0.37-1.0, P = 0.05), and this reduction was observed up to 24 months of treatment (OR = 0.41, 95% CI: 0.22-0.75, P < 0.004). Considering the limitations of the study, the use of ADs in NP therapy may have a significant impact on reducing the occurrence of severe pain up to 24 months of therapy and should be included in pharmacotherapy in this group of patients.