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Advances in Urology
Volume 2009, Article ID 797031, 9 pages
http://dx.doi.org/10.1155/2009/797031
Review Article

Antidepressant Drugs for Chronic Urological Pelvic Pain: An Evidence-Based Review

1Postgraduate Program in the Management of Pain, University of Ioannina School of Medicine, Greece
2Department of Psychiatry, University of Ioannina School of Medicine, Greece
3Department of Urology, University of Ioannina School of Medicine, Greece

Received 29 July 2009; Accepted 28 December 2009

Academic Editor: Flavio Trigo Rocha

Copyright © 2009 Christos Papandreou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The use of antidepressant drugs for the management of chronic pelvic pain has been supported in the past. This study aimed to evaluate the available evidence for the efficacy and acceptability of antidepressant drugs in the management of urological chronic pelvic pain. Studies were selected through a comprehensive literature search. We included all types of study designs due to the limited evidence. Studies were classified into levels of evidence according to their design. Ten studies were included with a total of 360 patients. Amitriptyline, sertraline, duloxetine, nortriptyline, and citalopram are the antidepressants that have been reported in the literature. Only four randomized controlled trials (RCTs) were identified (two for amitriptyline and two for sertraline) with mixed results. We conclude that the use of antidepressants for the management of chronic urological pelvic pain is not adequately supported by methodologically sound RCTs. From the existing studies amitriptyline may be effective in interstitial cystitis but publication bias should be considered as an alternative explanation. All drugs were generally well tolerated with no serious events reported.