Antidepressants prescribed for pain in older adults despite weak evidence of effectiveness | The study found that in the last 40 years there have been only 15 trials globally focusing on the benefit of antidepressants for pain in older people.

From the article: [The study](https://doi.org/10.1111/bcp.16234) found that in the last 40 years there have been only 15 trials globally focusing on the benefit of antidepressants for pain in older people. This study fills a much-needed gap in research by bringing together the information from these trials to look at the efficacy and harms of antidepressants for acute and chronic non-cancer pain in those over 65-years old.

It finds a lack of evidence to inform the use of antidepressants for most pain conditions in older adults, and urges prescribing and treatment practices that consider the unique needs and risks of older adults.

Lead author Dr Sujita Narayan, a Research Fellow at the University’s Institute for Musculoskeletal Health said international guidelines recommending antidepressants for chronic pain are heavily based on studies that either exclude older adults or include only a small number of them.

Health professionals use these as a reference point when treating older patients with conditions causing chronic pain, such as osteoarthritis.

“If I am a busy clinician and want to look at the guidelines for quick reference, I will probably have time to look at only the key points regarding management of chronic pain, some of which advise the use of antidepressants,” said Dr Narayan, from the Faculty of Medicine and Health.

Senior author Associate Professor Christina Abdel Shaheed from the University’s School of Public Health and the Institute for Musculoskeletal Health emphasised no trials examined the growing use of antidepressants for acute pain such as that experienced by those with shingles or muscular pain.

“These medicines are being prescribed to remedy patients’ pain, despite the lack of evidence to adequately inform their use,” Associate Professor Abdel Shaheed said. “However, harms of antidepressant use in older people are well documented.”

I thought it was prescribed because many chronic pain conditions create depression that is relived by antidepressants.