Low-dose of Amitriptyline effective in idiopathic chronic neck pain

The efficacy of Amitriptyline a known antidepressant has been established for many chronic pain conditions. Dr.Maarrawi J and colleagues conducted a Randomized controlled study to evaluate the efficacy of low dosage amitriptyline in chronic neck pain. The investigators found that low-dose amitriptyline is effective for the management of idiopathic CNP with few side effects and high patients' satisfaction. This implies that low-dose amitriptyline significantly reduces pain and improves disability in patients with idiopathic chronic neck pain (CNP).The study has been published in European Journal of Pain.

The researchers conducted a randomized controlled study of 220 patients (amitriptyline group, n=112; placebo group, n=108) with CNP between March 2012 and December 2015. The patients were assessed using visual analog scale (VAS), Bergen insomnia scale, hospital anxiety and depression scale (HADS), and neck pain disability index (NPDI).

The investigators found that overall, 8 patients experienced side effects in the amitriptyline group because of intolerance and were withdrawn from the study.The pain intensity after 2-month treatment period in the amitriptyline group was significantly lower vs placebo group (mean VAS score, 3.34±1.45 vs 6.12±0.92; P<.0001).Further in the amitriptyline group, calculated VAS improvement was significantly higher (53.06%±20.29%) vs placebo group (14.41%±11.05%; P<.0001).There was a significant improvement in NPDI (P<.0001), patient satisfaction (P<.0001), sleep disturbance (P<.0001), and HADS (P<.0001) in the amitriptyline group vs placebo group.

The authors concluded that low-dose amitriptyline is effective for the management of idiopathic CNP with few side effects and high patients' satisfaction.

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