Screen for depression RCT of 12 months optimized antidepressant therapy and pain self-management in primary care patients with depression and musculoskeletal pain
50% reduction in baseline depression severity
Statistically significant improvements in pain severity, anxiety and quality of life
Tricyclics
Low dose, 10-12 hours before arising
Amitriptyline best studied, >50mg increased side effects without added benefit
Other antidepressants
SSRIs not as effective
Bupropion, SNRIs (venlafaxine, duloxetine) may be effective
