The findings, based on moderate certainty evidence, show that for people with back pain the effects were too small to be worthwhile, but for osteoarthritis, a small beneficial effect cannot be ruled out.

Most clinical practice guidelines recommend antidepressants for long term (chronic) back pain and hip and knee osteoarthritis, yet evidence supporting their use is uncertain.To address this knowledge gap, researchers led by Giovanni Ferreira at the University of Sydney set out to investigate the effectiveness and safety of antidepressants for back and osteoarthritis pain compared with placebo.

Their findings are based on analysis of published data from 33 randomised controlled trials involving more than 5,000 adults with low back or neck pain, sciatica, or hip or knee osteoarthritis.