Depression Drugs Treat Arthritis Pain

Osteoarthritis pain reduced in patients taking duloxetine

(RxWiki News) Even if a drug was designed to treat one specific disease, it often happens that the same drug can help patients with other conditions. This seems to be the case with a popular antidepressant drug.

Duloxetine, an antidepressant drug sold under the brand name Cymbalta, appears to be an effective treatment for osteoarthritis pain.

"Ask your doctor about all your options for reducing arthritis pain."

Osteoarthritis patients are often prescribed non-steroidal anti-inflammatory drugs (NSAIDs) to treat pain.

In a recent study, Leslie Citrome, M.D., M.P.H., of New York Medical College, and Amy Weiss-Citrome, M.D., a private practice doctor in Pomona, New York, wanted to see if antidepressants - alone or in combination with NSAIDs - could treat pain in patients with osteoarthritis.

They found that duloxetine is, in fact, effective in treating osteoarthritis pain.

"It is not uncommon to treat osteoarthritis with a combination of drugs that work in different ways," says Dr. Citrome. "Our review supports this approach and confirms that antidepressants are not just for depression and can play a key role in relieving this painful condition."

The researchers also found that duloxetine may offer some advantages over the traditional NSAID treatment. Specifically, duloxetine has fewer and less serious side effects when compared to NSAIDs, which can cause gastrointestinal bleeding, or opiates, which can cause constipation and other side effects.

For their study, Drs. Citrome and Weiss-Citrome analyzed their data using two measurements called "number needed to treat" (NNT) and "number needed to harm" (NNH). NNT measures how many patients need to receive one treatment versus another before one more patient gets a desired outcome.

NNH works similarly, except it looks for an undesired outcome, such as a harmful side effect.

The researchers found that the NNT was six when duloxetine was comported to a placebo, meaning six patients would need to be treated with duloxetine before one extra patient had improvement in pain.

This low NNT suggests that duloxetine may be a good option for osteoarthritis treatment.

Additionally, the risk of side effects in patients taking duloxetine were low when compared placebo.

Duloxetine alone has already been approved for treating power. However, according to Dr. Weiss-Citrome, "It is quite common for patients to receive a combination of drugs and NSAIDs."

For this reason, the researchers looked at another study analyzing the use of duloxetine in combination with NSAIDs for treating knee osteoarthritis.

They found that patients taking duloxetine and NSAIDs had a larger reduction in pain, compared to those who took NSAIDs and placebo.

According to Dr. Citrome, "We believe that our analysis of these studies demonstrates that clinicians managing patients suffering from osteoarthritis should also consider prescribing adjunctive antidepressants that can effectively impact on central pain pathways."

Within the last year, Dr. Leslie Citrome has been a consultant for, has received honoraria from, or has conducted clinical research supported by the following: Alexza, Alkermes, AstraZeneca, Avanir, Bristol-Myers Squibb, Eli Lilly, Janssen, Lundbeck, Merck Novartis, Noven, Otsuka, Pfizer, Shire, Sunovion, and Valeant.

Duloxetine is manufactured and marketed by Eli Lilly. As such, Dr. Citrone may have had a conflict of interest participating in this study.

The results of the study were published online ahead-of-print in the International Journal of Clinical Practice.

Review Date: 
April 8, 2012