Advances in Urology / 2009 / Article / Tab 1

Review Article

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

Table 1

Characteristics of studies assessing the efficacy of antidepressants in chronic pelvic pain.

StudyStudyLevel ofDiagnosisAntidepressants—Control groupSample sizeDuratin ofMain outcomeResults
design evidence dosage (age rang)studyMeasures

Van Ophoven
et al. 2004 [11]
RCTIIInterstitial cystitisAmitriptyline—25–100 mg/dayplacebo (NA)4 monthsChange from baseline in the O’Leary-Sant Interstitial Cystitis Symptom Index (ICSI)Mean reduction in symptom score of 8.4 for amitriptyline versus 3.5 for the placebo group (P < .005)
Sator-Katzenschlager et al. 2005 [12]RCTIIChronic pelvic painAmitriptyline—25–150 mg/dayGabapentin/Gabapentin + Amitriptyline 24 monthsChange from baseline in pain intensitySignificant pain relief in all patients. Pain relief significantly better in patients receiving gabapentin either alone or in combination with amitriptyline than in patients on amitriptyline alone
Van Ophoven and Hertle 2005 [13]Consecutive (prospective)
case series
IIIBInterstitial cystitisAmitriptyline—12.5–150 mg/dayuncontrolled (NA)mean:19 month
Change from baseline in the overall well-being (global response assessment questionnaire)Statistically significant improvement in symptoms compared to baseline
Hanno et al.
1989 [14]
case series
IIIBInterstitial cystitisAmitriptyline—75 mg/dayuncontrolled (21–83)mean:16.4 months
Change from baseline in pain, daytime frequency, nocturiaStatistically significant improvement in pain and daytime frequency compared to baseline. No significant improvement in nocturia
Pranikoff and Constantino
1998 [15]
case series
IVChronic urinary frequency and painAmitriptyline—25–100 mg/dayuncontrolled (21–76)3 monthsChange from baseline in symptomsComplete resolution of symptoms in 11 patients and some residual symptoms present in 6.
Engel et al.
1998 [16]
RCTIIChronic pelvic painSertraline—100 mg/dayplacebo (19–45)14 weeksChange from baseline in the Composite Pain Intensity scoreNo significant improvement in pain compared to placebo
Lee et al.
2005 [17]
RCTIIChronic pelvic painSertraline—50 mg/dayplacebo (18–65)26 weeksChange from baseline in prostatic symptom frequency and severity scoresNo significant improvement in pain severity (P = .34) and a nonsignificant trend for improvement in pain frequency (P = .09) compared to placebo
Walker et al.
1991 [18]
case series
IIIBChronic pelvic painNortriptyline—100 mg/dayuncontrolled (NA)1 yearChange from baseline in pain intensitySignificant improvement in pain intensity compared to baseline (P < .05)
Van Ophoven and Hertle 2007 [19]Consecutive (prospective)
case series
IIIBInterstitial cystitisDuloxetine—80 mg/dayuncontrolled (25–69)2 monthsChange from baseline in the overall well-being (global response assessment questionnaire)No significant improvement in symptoms compared to placebo
Brown et al.
2008 [20]
Consecutive (prospective)
case series
IIIBChronic pelvic painCitalopram—
20–60 mg/day
uncontrolled (18–50)3 monthsChange from baseline in pain quality and intensityNo significant differences in the quality of pain. Trend towards improvement in pain intensity (P = .096)

RCT: randomized controlled trial; NA: not available; see methods for definition of study design classification and level of evidence.

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