Another Indication for Amitriptyline: Managing Chronic Neck Pain

The efficacy of amitriptyline (Elavil® and others) has been established for a variety of pain conditions, but has been understudied for the management of chronic neck pain (CNP), the optimal treatment approach for which has remained controversial. A new study supported by the Council of Research of the Saint Joseph University of Beirut – Lebanon performed a randomized double-blind analysis of bedtime low-dose amitriptyline vs placebo in patients with idiopathic CNP, and has returned encouraging results. The research concludes that low-dose amitriptyline is effective for management of this pain condition, with low risk of adverse effects and high patient satisfaction. The findings are published this month in the European Journal of Pain.

In the study, 220 patients with idiopathic CNP were randomized to receive 5 mg of amitriptyline or placebo at bedtime for 2 months. Outcome measures, taken before and after the study interval, were visual analog scale for pain (primary outcome), with secondary outcomes measured by neck pain disability index, Bergen Insomnia Score, and Hospital Anxiety and Depression Scale. Patient satisfaction was assessed at the conclusion of the study only. The amitriptyline cohort recorded significantly improved measures of primary outcome, and lesser but still significant improvement in secondary measures compared to placebo. The authors conclude that the trial findings are significant in that “It extends the indication of low-dose amitriptyline to another chronic pain condition.”

Read the journal abstract here.

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