Low doses of the tricyclic antidepressant amitriptyline may provide some relief for chronic low back pain, a JAMA Internal Medicine study suggests.
Nearly 150 adults with chronic, nonspecific low back pain were randomized to receive either low-dose (25 mg) amitriptyline or 1-mg benztropine (an active control with similar adverse events as amitriptyline) every day for 6 months.
The primary outcome — pain intensity at 3 and 6 months — was lower with amitriptyline, but the difference between the treatments was not statistically significant. However, the amitriptyline group did have significantly lower disability scores at 3 months. Few adverse events were reported at 6 months.
The authors conclude: “Although large-scale clinical trials that include dose escalation are needed, it may be worth considering low-dose amitriptyline if the only alternative is an opioid.”