Anti-depressants reduce pain in opioid-dependent patients

by Bruce Sylvester – Researchers report that opioid-dependent patients treated with escitalopram achieved meaningful reductions in pain severity and pain interference during the first three months of therapy. The findings were published in the November, 2011 issue of the journal Pain.

As background the authors noted that pain is common among opioid-dependent patients, and methadone-treated patients, chronic pain prevalence estimates range from 37-61 percent.

The investigator analyzed longitudinal data from a randomized, controlled trial that evaluating the effects of escitalopram on treatment retention in patients with depressive symptoms who were initiating buprenorphine/naloxone for treatment of opioid dependence.

Subjects were randomized to receive 10 mg/daily of escitalopram, or a placebo.

Clinicians evaluated changes in pain severity, pain interference and depression at one, two and three-month visits, using the visual analog scale, Brief Pain Inventory, and the Beck Depression Inventory II.

“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 Boston University School of Medicine. “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.

Funding for this study was provided by the National Institute on Drug Abuse.