Efficacy of tramadol–acetaminophen tablets in low back pain patients with depression

Tramadol–acetaminophen tablets are currentlyused to treat pain, including that of degenerative lumbar disease. Although there are many reports on tramadol–acetaminophen tablets, treatment outcomes in low back pain (LBP) patients with depression remain uncertain.This study investigated the outcomes of LBP patients with depression treated with tramadol–acetaminophen tablets. Of 95 patients with chronic LBP, 70 (26 men,44 women; mean age 64 years) who were judged as having depression by the Self-Rating Depression Scale (SDS) wereincluded in this study. In this trial, patients received one of two randomly assigned 8-week treatment regimes: tramadol–acetaminophen (Tramadol group, n = 35) and non-steroidal anti-inflammatory drugs (NSAIDs) (NSAID group, n = 35). In addition to completing self-report questionnaires, patients provided demographic and clinical information. All patients were assessed using a Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), Pain DisabilityAssessment Scale (PDAS), Hospital Anxiety and Depression Scale (HADS), SDS, and Pain Catastrophizing Scale (PCS). After 8 weeks’ treatment, the NRS and SDS scoreswere lower in the Tramadol group than in the NSAID group (p < 0.05). There were no significant differences in the ODI,PDAS, and PCS scores between the groups (p = 0.47, 0.09, 0.47). Although there was no difference in the anxiety componentof the HADS between the groups (p = 0.36), the depression component was lower in the Tramadol group than in the NSAID group (p < 0.05). There was no significant difference between groups in the percentage of patients with treatment-associated adverse events. This investigation found that tramadol–acetaminophen is effective for reducing LBP and provided a prophylactic antidepressant effect in chronic LBP patients with depression.