Does Pain Interfere with Antidepressant Depression Treatment Response and Remission in Patients with Depression and Pain? An Evidence‐Based Structured Review. Issue 9 (19th August 2014)

• Record Type: Journal Article
• Authors: Fishbain, David A.; Cole, Brandly; Lewis, John E.; Gao, Jinrun
• Is Part Of: Pain medicine. Volume 15:Issue 9(2014)
• Page Start: 1522
• Page End: 1539
• Publication Date: 2014-08-19
• Subjects: Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1111/pme.12448
• Languages: English
• ISSNs: 1526-2375

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="pme12448-sec-0001" sec-type="section"> <title>Objective</title> <p>The objective of this evidence‐based structured review was to determine if there is consistent evidence that pain interferes with achieving antidepressant treatment response/remission of depression in patients with depression and pain.</p> </sec> <sec id="pme12448-sec-0002" sec-type="section"> <title>Methods</title> <p>After exclusion criteria were applied, of 2, 801 studies/reports, 17 studies addressed this question. They were sorted into the four hypotheses outlined hereinafter. The percentage of studies supporting/not supporting each hypothesis was calculated. The strength and consistency of the evidence for each hypothesis were rated according to the Agency for Health Care Research and Quality (AHRQ) guidelines.</p> </sec> <sec id="pme12448-sec-0003" sec-type="section"> <title>Results</title> <p>For the first hypothesis (pretreatment pain levels will predict antidepressant depression response), nine out of 10 (90%) studies supported it. For the second hypothesis (treatment decreases in pain will be associated with antidepressant depression response), two out of two (100%) studies supported it. For the third hypothesis (pretreatment pain levels will predict antidepressant depression remission), six out of six (100%) studies supported it. For the fourth hypothesis (treatment decreases in pain will be associated with antidepressant depression remission), five out of five (100%) supported it. Utilizing these percentages and AHRQ guidelines, hypotheses 1, 3, and 4 received an A rating for consistency of studies in supporting them. A consistency rating for hypothesis 2 could not be generated because of too few studies in that group.</p> </sec> <sec id="pme12448-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Consistent evidence was found that antidepressant treatment of depression in patients with depression and pain can be negatively impacted by pain for achieving depression response/remission. However, the overall number of studies supporting each hypothesis was small. In addition, several potential confounders of the results of this study were identified.</p> </sec> </abstract>