Among antidepressants, only serotonin-norepinephrine reuptake inhibitors are effective for pain

Clinical Question

Which antidepressant classes are effective for which pain syndromes?

Bottom line

This umbrella review, summarizing the results of the most comprehensive systematic reviews of the use of antidepressants to treat various pain syndromes, found the only good evidence supported the use of SNRIs (eg, duloxetine, venlafaxine) to treat some types of pain, including back pain, postoperative pain, neuropathic pain, and fibromyalgia. Based on either moderate or low-quality evidence, other antidepressants in other classes were not effective for these types of pain or any others. 1a

Study design: Meta-analysis (other)

Funding: Self-funded or unfunded

Setting: Other


Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA

Discuss this POEM


Thomas Lobsinger

Among antidepressants, only serotonin-norepinephrine reuptak

This contradicts other studies suggesting the benefit of TCA's in various pain syndromes which reflects my experience.


Impact assessment

Very good


Snri and pain management

Confirms previous findings