Condition | AD treatment, role in strategy, rating of the recommendation | Comments and role of other treatments |
---|---|---|
ADs recommended: | -Similar statements between guidelines: | |
- TCAs: Amitriptyline first line (25–150 mg/day, Level A) Nortriptyline (alternative option) [22–26] NNT of 3.6 (95% CI: 3-4.5). | -Strong consensus for TCAs and venlafaxine. | |
-SNRIs: Venlafaxine, fist line treatment (Level A) NNT of 3.1 Duloxetine: option | -Gabapentin, Pregabalin: also recommended as first-line treatments. TCAs are equally effective compared to non-AD drugs gabapentin (1200–3600 mg/day) and pregabalin (150–600 mg/day) | |
SSRI: not recommended | ||
ADs recommended: | Â | |
-Duloxetine 60 mg and 120 mg daily, first-line, (Level A) The NNT for effectiveness was 1.3 (95% CI: 1.2- 1.5). This AD has on-label use for this condition [25, 26, 28] | Duloxetine: conflicting evidence between guidelines, just cited as a therapy for NP in the EFNS GL[24], and only for PDN in the Cochrane Review | |
-Venlafaxine 150–225 mg/day; first line (no level mentioned)TCA : If other ADs contraindicated, Amitriptyline is an option | Venlafaxine might be added to gabapentin for a better response (Level C). | |
SSRIs: not recommended | ||
HIV-related neuropathies[27] | No AD treatment recommended | -Evidence not to prescribe any AD |
- Recommended non-AD treatments: -lamotrigine (Level B), smoking cannabis (Level A), capsaicin patches (Level A) | ||
Phantom limb pain[30] | No AD treatment recommended | Amitriptyline was not different from placebo |
-ADs are not first-line treatment | -Similar statements but lack of comparative trials to assess a precise role for TCAs and venlafaxine. | |
-ADs recommended: TCA or venlafaxine are alternative treatments | First-line: carbamazepine (Level A) and oxcarbazepine (Level B) | |
-ADs are not first-line treatments | -Similar statements but lack of comparative trials to assess a precise role for TCAs and venlafaxine | |
- ADs recommended: TCA or venlafaxine are alternative treatments | -First-line: gabapentin / pregabalin (Level A) | |
Central pain 2[24] | -ADs are not first-line treatment | -Similar statements between guidelines |
- ADs recommended: TCAs: Amitriptyline second-line (Level B)- SNRIs: Duloxetine and venlafaxine second choice (Level B) | -Pregabalin: first-line (level A) | |
ADs recommended: | -Similar statements for TCAs, and SSRIs. Disagreement for the usefulness of venlafaxine | |
-TCA: Amitryptiline 25-150 mg per day, (Level A).-Venlafaxine 75-150 mg was presented as an effective alternative to tricyclic antidepressants (Level B) | -TCA: In cases of TTH with associated drug abuse, the role of this treatment was only mentioned, with no rating, by the French HAS. | |
SSRIs: not recommended | ||
No AD treatments recommended | Only to be prescribed as an option in the event of associated depression (NICE) | |
Very weak evidence for TCAs observed by the French HAS (level C) | ||
ADs recommended: | Alternative pharmacological options: Gabapentin, tramadol | |
SNRIs: Milnacipran 12.5 mg once daily, target dose of 50-100 mg two times per day | ||
-Duloxetine: 60 mg twice daily, -Venlafaxine could be prescribed -TCAs showed evidence | ||
SSRIs: not recommended | ||
Burning mouth syndrome[39] | No AD treatments recommended | -Two RCTs showed no antidepressant effects |