Treating the Physical Symptoms of Depression With Second-Generation Antidepressants: A Systematic Review and Metaanalysis

BackgroundApproximately two-thirds of patients with depression experience physical pain symptoms. Coexisting pain complicates the treatment of depression and is associated with worse depression outcomes.ObjectiveThe authors reviewed the effect of newer antidepressants on pain in patients with depression.MethodThe authors searched systematically for trials of second-generation antidepressants that enrolled depression patients and reported pain outcomes, pooling changes on the pain visual-analog scale (VAS), using random-effects models.ResultsEight trials were eligible. Pooled analysis of head-to-head trials showed no difference in VAS between duloxetine and paroxetine. Both drugs were superior to placebo.ConclusionThe authors found insufficient evidence to support the choice of one second-generation antidepressant over another in patients with pain accompanying depression.