Treatment of functional chest pain with antidepressants: a meta-analysis Full Text
Pain Physician, 03/26/2012  Evidence Based Medicine

Wang W et al. – Antidepressant medications are associated with improvements in pain and psychological symptoms. The effects of factors including psychiatric co–morbidity, gender, age, ethnic group, and treating period on the outcomes should be checked further.

• MEDLINE, PsycINFO, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to July 2011.
• Randomized controlled trials (RCTs) that tested any type of antidepressants for FCP with normal coronary anatomy were analyzed.
• Randomized controlled trials (RCTs) that tested any type of antidepressants for FCP with normal coronary anatomy were analyzed.
• Diagnoses included non–specific chest pain, noncardiac chest pain, atypical chest pain, syndrome X, or chest pain with normal coronary anatomy.
• Two authors independently extracted data.
• Effects were summarized using standardized mean differences (SMDs), weighed mean differences (WMD), or odds ratio (OR) by suitable effects model.

• Seven RCTs (median duration, 5 weeks; range, 3 – 16 weeks) involving 319 participants were included.
• There was strong evidence for an association of antidepressants with reduction in pain (SMD –1.26; 95% confidence interval [CI], –2.34 to –0.19) and psychological symptoms (SMD –0.87; 95% CI, –1.67 to – 0.08) as well as increased side effects (OR 0.34; 95% CI, 0.15 to 0.78).
• Current analysis did not support the association of antidepressants with improved health related quality of life (WMD 2.00; 95% CI, – 2.54 to – 6.65).