Mianserin and chronic pain: a double-blind placebo-controlled process and outcome study

Abstract

There is evidence that antidepressants may have an analgesic effect in chronic pain. To replicate this effect and to throw light on the processes involved, a 12-week cross-over double-blind trial of mianserin versus placebo was carried out in 4 diagnostic groups: A) depressive patients without pain complaints (n = 8), B) depressive patients with chronic organic pain (n = 8), C) patients with somatoform pain disorder and vital signs of depression (n = 11) and D) patients with chronic organic pain without depression (n = 8). Although a mianserin-induced antidepressant effect in group A was evident, no significant pain reduction was accomplished in any group. The reasons for this failure to replicate the antidepressant-induced analgesic effect are discussed.