Table 1 Characteristics of included systematic reviews and meta analyses studies
| Â | First author, Year, Country | Type of pain/ Outcome | Number/ Types of study included | Types of treatment | Results in terms of pain reduction/ Side effects |
|---|---|---|---|---|---|
1 | Riediger C, 2017 [12], Germany | CLBP/ Adverse events | Total:23, LBP:5/RCTs | TCAs: Amitriptyline, Desipramine, Nortriptyline, SNRIs: Venlafaxine, Milnacipran, Duloxetine, TeCAs: Mirtazapine, SSRIs: Fluoxetine | Higher risk for adverse effects compared to placebo, except nortriptyline. |
Onghena P, 1992 [32], Belgium | CLBP/ Pain | Total:39, LBP: 5 /RCTs | TCAs: Imipramine, Doxepin, Amitriptyline | Effective results in pain relief | |
2 | Chung JWY, 2013 [18], China | CNLBP/ Pain, Global Improvement, Adverse events | Total:25, ADs:4/ RCTs | No specific subgroups | Statistically significant treatment effects in pain relief and side effects |
3 | Pinto RZ, 2012 [33], Australia | LBP, Sciatica/ Pain, Function | Total:23, ADs: 1/RCT | TCAs: Nortriptyline | No significant results in pain relief Data were insufficient |
4 | Urquhart DM, 2010 [34], Australia | NLBP/Pain, Function, Depression | 10 RCTs | TCAs SSRIs | No clear evidence of effectiveness |
5 | Machado LAC, 2009 [35], Australia | CNLBP/ Pain | Total:74, ADS: 4/ RCTs | No specific subgroups | Small analgesic effect |
6 | Salerno SM, 2002 [36], USA | CLBP/ Pain, Function | 9 RCTs | TCAs: Nortriptyline, Imipramine, Amitriptyline, TeCAs: Maprotiline, SSRIs: Paroxetine, SNRIs: Duloxetine, Others: Trazodone | Effective results in pain relief |
8 | Chou R, 2017 [11], USA | CLBP/ Pain, Function, Depression | Total:79, ADs: 16/1SR + 6RCTs | TCAs SSRIs SNRIs: Duloxetine | SNRIs: Effective on pain reduction TCAs and SSRIs: No significant results |
9 | Van Den Driest JJ, 2017 [17], The Netherlands | CLBP/Pain, Function, Adverse events | Total:7/ LBP: 4 | TCAs: Amitriptyline vs. Pregabalin | Effective results in pain relief Similar side effect with comparator |
10 | National Guideline Centre (UK), 2016 [2],UK | LBP, Sciatica/ Pain, Function, Adverse events | Total:55, ADs: 10/RCTs | TCAs, SSRIs, SNRIs | No clear evidence of effectiveness. SSRIs, SNRIs significant adverse event |
11 | Chou R, 2016 [37], USA | CLBP/ Pain, Function | Total:153, ADs: 4 /1SR + 3 RCTs | TCAs, SSRIs, SNRIs: Duloxetine | SSRIs and TCAs: No effect on pain reduction SNRIs: small effect on pain reduction |
12 | Mercier A,2013 [38], France | NLBP, Sciatica/ Pain | Total:78, LBP:3/ RCTs | No specific subgroups | No AD treatments recommended. Only in the event of associated Depression |
13 | RomanoCL,2012 [39], Italy | CLBP/ Pain, Function, Depression | Total: 6, ADs: 1/ RCT | TCAs: Nortriptyline | No significant results for monotherapy |
14 | Morlion B, 2011 [40], Belgium | LBP/ pain, Function | Ads:10 | No specific subgroups | Small benefits for Ads. TCAs are recommended |
15 | Kuijpers T, 2011 [16], The Netherlands | CNLBP/ Pain, Function, Adverse events | Total: 17, ADS: 5 / SR and MA | No specific subgroups | No clear evidence of effectiveness and side effects |
16 | Savigny P,2009 [41], UK | NLBP/ Pain, Function, Depression | 1SR+  10 RCTs | TCAs, SSRIs, SNRIs | No clear evidence of effectiveness |
17 | Chou R, 2007 [15], USA | CLBP/ Pain, Function, Adverse events | 3 SR | TCAs: Nortriptyline, Imipramine, Amitriptyline, Desipramine SSRIs: Paroxetine SNRIs: Duloxetine, Venlafaxine Others: Maprotiline, Trazodone | Only TCAs have been shown effective. No evidence on SNRIs, SSRIs. Insufficient evidence for Others. Significantly higher risk for any adverse event. |
18 | Staiger THO, 2003 [42], USA | CLBP/ Pain, Function | 7 RCTs | TCAs: Nortriptyline, Imipramine, Amitriptyline, SSRIs: Paroxetine, TeCAs: Maprotiline, Others: Trazodone | TCAs and TeCAs: moderate symptom reductions SSRIs: Not beneficial |
19 | White AP,2011 [43], USA | CLBP/ Pain, Function, Adverse events | Total: 6 | TCAs: Desipramine, Imipramine SSRIs: Paroxetine, Fluoxetine | No effective than placebo. No differences between differing types of ADs. |
20 | Cawston H,2013 [44], France | CLBP/Pain | 4 RCTs+ MAs | SNRIs: Duloxetine | No difference in efficacy between duloxetine and other oral pharmacological therapies. |
21 | Qaseem A, 2017 [45], USA | CLBP/ Pain | 9 RCTs | TCAs SSRIs SNRIs: Duloxetine | No difference between SSRIs and TCAs. Duloxetine had small effect |
22 | Perrot S, 2006 [46], France | CLBP/ Pain | Total:99 4 on CLBP | TCAs: Nortriptyline, Imipramine, Amitriptyline, TeCAs: Maprotiline SSRIs: Paroxetine | TCAs and TeCAs: Moderate symptom reductions SSRIs: Not Beneficial |
23 | Perrot S, 2008 [47],France | CLBP/ Pain | Total:52 11 on CLBP | TCAs: Nortriptyline, Imipramine, Clomipramine, Amitriptyline SSRIs: Paroxetine, Bupropion TeCAs: Maprotiline Others: Trazodone | SSRIs seem to be less effective than TCAs |
24 | Patetsos E,2016 [48], Denmark | CLBP/ Pain | Total:36 2 on CLBP | SSRIs: Paroxetine | No significant results |
25 | Schnitzer Th J,2004 [49], USA | CLBP/ Pain | Total: 55, ADs: 7 RCTs | No specific subgroups | Evidence exists regarding the efficacy of antidepressants |