Abstract
Background
Chronic pain is common in adults, and often has a detrimental impact upon physical ability, well‐being, and quality of life. Previous reviews have shown that certain antidepressants may be effective in reducing pain with some benefit in improving patients’ global impression of change for certain chronic pain conditions. However, there has not been a network meta‐analysis (NMA) examining all antidepressants across all chronic pain conditions.
Objectives
To assess the comparative efficacy and safety of antidepressants for adults with chronic pain (except headache).
Search methods
We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS, AMED and PsycINFO databases, and clinical trials registries, for randomised controlled trials (RCTs) of antidepressants for chronic pain conditions in January 2022.
Selection criteria
We included RCTs that examined antidepressants for chronic pain against any comparator. If the comparator was placebo, another medication, another antidepressant, or the same antidepressant at different doses, then we required the study to be double‐blind. We included RCTs with active comparators that were unable to be double‐blinded (e.g. psychotherapy) but rated them as high risk of bias. We excluded RCTs where the follow‐up was less than two weeks and those with fewer than 10 participants in each arm.
Data collection and analysis
Two review authors separately screened, data extracted, and judged risk of bias. We synthesised the data using Bayesian NMA and pairwise meta‐analyses for each outcome and ranked the antidepressants in terms of their effectiveness using the surface under the cumulative ranking curve (SUCRA). We primarily used Confidence in Meta‐Analysis (CINeMA) and Risk of Bias due to Missing Evidence in Network meta‐analysis (ROB‐MEN) to assess the certainty of the evidence. Where it was not possible to use CINeMA and ROB‐MEN due to the complexity of the networks, we used GRADE to assess the certainty of the evidence.
Our primary outcomes were substantial (50%) pain relief, pain intensity, mood, and adverse events. Our secondary outcomes were moderate pain relief (30%), physical function, sleep, quality of life, Patient Global Impression of Change (PGIC), serious adverse events, and withdrawal.
Main results
This review and NMA included 176 studies with a total of 28,664 participants. The majority of studies were placebo‐controlled (83), and parallel−armed (141). The most common pain conditions examined were fibromyalgia (59 studies); neuropathic pain (49 studies) and musculoskeletal pain (40 studies). The average length of RCTs was 10 weeks. Seven studies provided no useable data and were omitted from the NMA. The majority of studies measured short‐term outcomes only and excluded people with low mood and other mental health conditions.
Across efficacy outcomes, duloxetine was consistently the highest‐ranked antidepressant with moderate‐ to high‐certainty evidence. In duloxetine studies, standard dose was equally efficacious as high dose for the majority of outcomes. Milnacipran was often ranked as the next most efficacious antidepressant, although the certainty of evidence was lower than that of duloxetine. There was insufficient evidence to draw robust conclusions for the efficacy and safety of any other antidepressant for chronic pain.
Chronic pain is common in adults, and often has a detrimental impact upon physical ability, well‐being, and quality of life. Previous reviews have shown that certain antidepressants may be effective in reducing pain with some benefit in improving patients’ global impression of change for certain chronic pain conditions. However, there has not been a network meta‐analysis (NMA) examining all antidepressants across all chronic pain conditions.
Objectives
To assess the comparative efficacy and safety of antidepressants for adults with chronic pain (except headache).
Search methods
We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS, AMED and PsycINFO databases, and clinical trials registries, for randomised controlled trials (RCTs) of antidepressants for chronic pain conditions in January 2022.
Selection criteria
We included RCTs that examined antidepressants for chronic pain against any comparator. If the comparator was placebo, another medication, another antidepressant, or the same antidepressant at different doses, then we required the study to be double‐blind. We included RCTs with active comparators that were unable to be double‐blinded (e.g. psychotherapy) but rated them as high risk of bias. We excluded RCTs where the follow‐up was less than two weeks and those with fewer than 10 participants in each arm.
Data collection and analysis
Two review authors separately screened, data extracted, and judged risk of bias. We synthesised the data using Bayesian NMA and pairwise meta‐analyses for each outcome and ranked the antidepressants in terms of their effectiveness using the surface under the cumulative ranking curve (SUCRA). We primarily used Confidence in Meta‐Analysis (CINeMA) and Risk of Bias due to Missing Evidence in Network meta‐analysis (ROB‐MEN) to assess the certainty of the evidence. Where it was not possible to use CINeMA and ROB‐MEN due to the complexity of the networks, we used GRADE to assess the certainty of the evidence.
Our primary outcomes were substantial (50%) pain relief, pain intensity, mood, and adverse events. Our secondary outcomes were moderate pain relief (30%), physical function, sleep, quality of life, Patient Global Impression of Change (PGIC), serious adverse events, and withdrawal.
Main results
This review and NMA included 176 studies with a total of 28,664 participants. The majority of studies were placebo‐controlled (83), and parallel−armed (141). The most common pain conditions examined were fibromyalgia (59 studies); neuropathic pain (49 studies) and musculoskeletal pain (40 studies). The average length of RCTs was 10 weeks. Seven studies provided no useable data and were omitted from the NMA. The majority of studies measured short‐term outcomes only and excluded people with low mood and other mental health conditions.
Across efficacy outcomes, duloxetine was consistently the highest‐ranked antidepressant with moderate‐ to high‐certainty evidence. In duloxetine studies, standard dose was equally efficacious as high dose for the majority of outcomes. Milnacipran was often ranked as the next most efficacious antidepressant, although the certainty of evidence was lower than that of duloxetine. There was insufficient evidence to draw robust conclusions for the efficacy and safety of any other antidepressant for chronic pain.
| Original language | English |
|---|---|
| Article number | CD014682 |
| Number of pages | 487 |
| Journal | Cochrane Database of Systematic Reviews |
| Volume | 2023 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 10 May 2023 |
Bibliographical note
Funding Information:• Five studies were partially funded by pharmaceutical companies.
Funding Information:
lenkov and Brown were participating investigators in the conduct of this study and received funding from Eli Lilly and Company.
Funding Information:
Part funded by pharmaceutical: "This work was supported by CIHR (Canadian Institutes ofHealth) Grant CIHR-MOP-106489 and a CIHR-Pfizer R&D Collaborative Research Investigator Program (CIHR Grant MSH-55041)."
Funding Information:
Non-pharmaceutical: "This study was supported by a grant from the National Institute of Health/National Institute of Dental Research (1RO3DE10086-01)"
Funding Information:
This research was financially supported by Forest Research Institute, Inc., Jersey City, New Jersey, and Cypress Bioscience, Inc., San Diego, California. The study drug was manufactured by Pierre Fabre Medicament, Boulogne, France. Drug supply and data collection were managed by Forest Research Institute.
Funding Information:
Pharmaceutical: this work was sponsored by Eli Lilly and Company and Boehringer Ingelheim GmbH.
Funding Information:
Non-pharmaceutical: "This study was financially supported by: Danish Medical Research Council, Danish Medical Research Council-Region-III, Kleins legat, Geerd Jorgensens fond, Lundbeck Fonden, Mimi and Victor Larsens Fond, Danish Dental Association (FUT-foundation), Bryde Nielsen Fond, P. Carl Pe-tersens Fond, Ciba Geigy A/S, and Organon." "Per Bech has occasionally over the past 3 years until August 2008 received funding from and been speaker or member of advisory boards for pharmaceutical companies with an interest in drug treatment of affective disorders (Astra-Zeneca, Lilly, H. Lundbeck A/S, Lundbeck Foundation, Organon). All other authors declare that they have no conflicts of interests."
Funding Information:
Pharmaceutical: supported by Natco Pharma Limited, India
Funding Information:
Sunovion, Takeda, and Targacept; has received grant/research support from Feinstein Institute for Medical Research, GlaxoSmithKline, National Institute of Mental Health, PsychoGenics, Research Foundation for Mental Hygiene, and Singapore Medical Research Council; is a stock shareholder in Neu-roCog Trials; and has received royalties from the Brief Assessment of Cognition in Schizophrenia (BACS) and MATRICS Battery (BACS Symbol Coding).
Funding Information:
Partly pharmaceutical: supported by grants from the Arthritis Foundation, Multipurpose Arthritis Center grant no. AM-20613, and a clinical investigator grant from Syntex Co.
Funding Information:
Non-pharmaceutical: the contents of this article were developed under a grant from the Department of Education, National Institute on Disability and Rehabilitation Research (grant no. H133A060107).
Funding Information:
Dr Clauw has received grant support from Cypress Bioscience, Inc. and serves as a consultant to Cypress Bioscience, Inc, Forest Laboratories, Inc., Pierre Fabre Medicament, Pfizer Inc, Eli Lilly and Company, Wyeth Pharmaceuticals, and Proctor and Gamble.
Funding Information:
Non-pharmaceutical: "This study was supported by Grants 1RO1 AT 00402-01 and 1K24 AT 004095 from the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health, USA"
Funding Information:
Non-pharmaceutical: grants from Danish Regions (Grant no. 14/217) and the Research Foundation of Odense University Hospital. S.S. Gylfadottir was funded by a grant from the Novo Nordic Foundation (Grant no. 14OC0011633).
Funding Information:
This study was funded by an investigator-led research grant, which was awarded by Pfizer Ltd. J.B. received an honorarium to present the research findings internally to a Pfizer consultancy board. D.K.received consultancy fees and honoraria from Eli Lilly, Novo Nordisk, Abbott Diabetes Care, and Roche, companies providing medicine and monitoring equipment used by participants in this study. No other potential conflicts of interest relevant to this article were reported.
Funding Information:
"J.D.C. has been a speaker for Pfizer, Forest, Bristol Myers Squibb, Glaxo Smith Kline, Eli Lilly, and Sunovion. He has received grants from Pfizer Pharmaceuticals, GSK, Corcept, and Neurocrine. There were no other conflicts of interest in doing this research. This work was supported by a Forest Laboratories Investigator-initiated grant to B.H.N., and, in part, by National Institutes of Mental Health (NIMH) grant R01 MH100005 to D.C.S. The sources of funding had no involvement in any of the aspects of running this study, analyzing the data, or preparing this manuscript."
Funding Information:
Non-pharmaceutical: the study was on request supported by an educational grant from NV Organon, Oss, The Netherlands
Funding Information:
Pharmaceutical: This study was supported by a collaborative research grant from GlaxoSmithKline.
Funding Information:
Pharmaceutical: This trial was supported by a grant from Pierre Fabre Médicament.
Funding Information:
Partly funded by pharmaeutical: "This work was supported by NIH grants MH18764 and MH16744 and NIMH Mental Health Clinical Research Center grant MH41115, a grant from the Procter and Gamble Company, a grant from the Stanford University Health Sciences Research and Development Fund, and a grant from the Western Research and Development Office of the Veterns Administration."
Funding Information:
Pharmaceutical: "This study was sponsored by Angelini Pharma S.p.A. (S. Palomba, Pomezia, Rome, Italy)."
Funding Information:
Non-pharmaceutical: supported by the Department of Veterans Affairs, Veterans Health Administration, Rehabilitation Research and Development Service (grant no. B2573R)
Funding Information:
Cochrane Review Group funding acknowledgement: this project was funded by the National Institute for Health Research (NIHR) via Cochrane Infrastructure funding to Cochrane Pain, Palliative and Supportive Care (PaPaS). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. We acknowledge and thank the NIHR Health Technology Assessment programme (HTA) for funding this review. We thank Joanne Abbott (Information Specialist for Cochrane PaPaS Review Group) for developing and running the search strategy, and Iris Gordon (Information Specialist for Cochrane Eyes and Vision Review Group) for peer reviewing the search strategy. We thank the peer reviewers of the protocol Dr Sarah Nevitt, Kevin Pacheco-Barrios MD, Dr Christina Abdel Shaheed, and Prof Amanda C de C Williams, and consumer reviewers Harrison Nelson and Stella O’Brien. Cochrane Pain, Palliative and Supportive Care (PaPaS) supported the authors in the development of this review. The following people conducted the editorial process for this article. Sign-off Editor (final editorial decision): Dr Neil O'Connell, PaPaS Co-ordinating Editor, and Reader at Brunel University London Contact Editor: Bethan Copsey, Leeds Institute of Clinical Trials Research, University of Leeds, UK Managing Editor (selected peer reviewers, collated peer-reviewer comments, provided editorial guidance to authors, edited the article): Anna Erskine and Jessica Thomas (Oxford University Hospitals (OUH) NHS Foundation Trust, Oxford, UK) Assistant Managing Editor (conducted editorial checks and supported editorial team): Kerry Harding (Oxford University Hospitals (OUH) NHS Foundation Trust, Oxford, UK) Information Specialist (searching support): Joanne Abbott (Oxford University Hospitals (OUH) NHS Foundation Trust, Oxford, UK) Peer reviewers: Brian Duncan (consumer reviewer, Psychology); Dr Ye Jin, Mental Health centre, Yingkou, Liaoning, China (clinical reviewer); Giovanni Ferreira, Institute for Musculoskeletal Health & Sydney Musculoskeletal Health, The University of Sydney (clinical reviewer); José A López-López, Department of Basic Psychology and Methodology, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia (Spain) (clinical reviewer); Rachel Richardson (Cochrane Evidence Production and Methods Directorate), Sofia Tsokani (Cochrane Evidence Production and Methods Directorate). Copy-editing (initial copy-edit and final proofread): Denise Mitchell (Cochrane Evidence Production and Methods Directorate) Sign-off Editor (final editorial decision): Dr Neil O'Connell, PaPaS Co-ordinating Editor, and Reader at Brunel University London Contact Editor: Bethan Copsey, Leeds Institute of Clinical Trials Research, University of Leeds, UK Managing Editor (selected peer reviewers, collated peer-reviewer comments, provided editorial guidance to authors, edited the article): Anna Erskine and Jessica Thomas (Oxford University Hospitals (OUH) NHS Foundation Trust, Oxford, UK) Assistant Managing Editor (conducted editorial checks and supported editorial team): Kerry Harding (Oxford University Hospitals (OUH) NHS Foundation Trust, Oxford, UK) Information Specialist (searching support): Joanne Abbott (Oxford University Hospitals (OUH) NHS Foundation Trust, Oxford, UK) Peer reviewers: Brian Duncan (consumer reviewer, Psychology); Dr Ye Jin, Mental Health centre, Yingkou, Liaoning, China (clinical reviewer); Giovanni Ferreira, Institute for Musculoskeletal Health & Sydney Musculoskeletal Health, The University of Sydney (clinical reviewer); José A López-López, Department of Basic Psychology and Methodology, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia (Spain) (clinical reviewer); Rachel Richardson (Cochrane Evidence Production and Methods Directorate), Sofia Tsokani (Cochrane Evidence Production and Methods Directorate). Copy-editing (initial copy-edit and final proofread): Denise Mitchell (Cochrane Evidence Production and Methods Directorate)
Funding Information:
These studies were sponsored by Abbott Laboratories. Dr Rowbotham has served as a consultant to Abbott, Adynxx, Afferent Pharmaceuticals, Allergan, Arcion, Bristol Meyers Squibb, Cardiome, Flexion, Kyowa Hakko Kirin, Neurotherapeutics Pharma, NuvoResearch, Xenon, Xenoport, and Zalicus. Dr Stacey has received grant support from NeurogesX and Pfizer, and has served as a consultant to As-
Funding Information:
Pharmaceutical: funding was provided by Ehime University under a contract with Shionogi & Co. Ltd (pharmaceutical company).
Funding Information:
Non-pharmaceutical: "This work was supported by The Rosetrees’ Trust, grant number M11-F1, by the UK National Institute of Health (NIHR) Clinical Research Network and an NIHR Clinical Academic Fellowship to MR"
Funding Information:
Non-pharmaceutical: project grant from the Health Research Council of New Zealand (reference number: 14/152).
Funding Information:
Pharmaceutical: this study was funded by H. Lundbeck A/S
Funding Information:
Pharmaceutical: funded by Eli Lilly
Funding Information:
Supported by Pfizer in the form of study drug (0600B1-4439). Study authors report no CoIs.
Funding Information:
Pharmaceutical: This study was supported by an investigator-initiated grant from Forest Laboratories. All study drugs were provided by Forest Laboratories.
Funding Information:
Partly funded by pharmaceutical: supported by a grant of the Dutch Heart Foundation (grant nr. 1998B209) and an unconditional educational grant of Glaxo Smith Kline.
Funding Information:
Non-pharmaceutical: the study was supported by the Finnish Dental Society.
Funding Information:
Non-pharmaceutical: The study was funded by Physicians’ Services Incorporated (PSI) Grant PSI: 88-17.
Funding Information:
Non-pharmaceutical: "This research was supported by Shanghai Science and Technology Committee."
Funding Information:
Dr Branco has received grant support as an investigator and consultant for Pierre Fabre Medicament. Drs Zachrisson and Perrot have served as speakers and consultants for Pierre Fabre Medicament. Dr Mainguy is an employee and shareholder of Pierre Fabre Medicament. Medical writing assistance provided by Prescott Medical Communications Group was supported by Pierre Fabre Medicament.
Funding Information:
Non-pharmaceutical: part of a PhD project - financially supported by “Research Department of theS-chool of Medicine Shahid Beheshti University of Medical Sciences(SBUMS)” (Grant No 13/587).
Funding Information:
Non-pharmaceutical: "The study was supported by grants from the County Council of Ostergotland and the Swedish Association of the Neurologically Disabled"
Funding Information:
F. W. Bach reports to have been compensated as an Investigator in clinical trials on neuropathic pain sponsored by Pfizer and Grunenthal. N. B. Finnerup reports personal fees from Pfizer, grants and personal fees from Grunenthal, personal fees from Astellas, personal fees from Norpharma, grants from EU/EFPIA; outside the submitted work. T. S. Jensen reports to be on Advisory Board for Pfizer, Grunenthal, and Orion. The other authors have no conflicts of interest to declare.
Funding Information:
Non-pharmaceutical: supported by the National Institutes of Health, National Institute of Child Health and Human Development, National Institute of Neurological Disorders and Stroke (grant no. 1PO1 HD/ NS33988)
Funding Information:
LB has received research support and speaker fees from Forest Laboratories, Inc. and Forest Research Institute, Inc. RHP, JMT, and YL are full-time employees of Forest Research Institute, Inc., a wholly owned subsidiary of Forest Laboratories, Inc., and hold stock in the parent company. This study was supported by Forest Laboratories, Inc. The authors thank Allan Spera at Forest Research Institute, Inc. for his contributions to the study and development of this paper. The authors also thank Mildred Bahn at Prescott Medical Communications Group (Chicago, IL, USA) for medical writing assistance supported by Forest Research Institute, Inc.
Funding Information:
Partly funded by pharmaceutical: "This was an investigator-initiated trial supported by Pfizer with a grant of USD 52080 (grant no: WS368802). The trial was also supported by a grant from Odense University Hospital."
Funding Information:
Non-pharmaceutical: supported by NIH program project grant NINDS 21445 and NINDS K24 NS02164
Funding Information:
Non-pharmaceutical: thanks the CAPES scholarship for fund
Funding Information:
Pharmaceutical: funded by Meiji Seika Pharma Co, Ltd.
Funding Information:
Cochrane Review Group funding acknowledgement: this project was funded by the National Institute for Health Research (NIHR) via Cochrane Infrastructure funding to Cochrane Pain, Palliative and Supportive Care (PaPaS). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Funding Information:
Partly funded by pharmaceutical: sponsor: Northwestern University; Collaborators: Forest Laboratories; Shirley Ryan Ability; Lab Best Practice
Funding Information:
IG has received honoraria for consulting or being a member of an advisory board, or both for Pfizer. RLH has received research grant support from Pfizer. All other authors declare that they have no conflicts of interest.
Funding Information:
Pharmaceutical: supported by an unrestricted grant from Valeant (Canada) Inc.
Funding Information:
Partly funded by pharmaceutical: "Supported in part by an investigator-initiated research grant from GlaxoSmithKline"
Funding Information:
Partly supported by pharmaceutical: "The financial support by Roche Oy, Finland, is gratefully acknowledged."
Funding Information:
Drs Skljarevski and Desaiah, Ms Zhang, and Ms Alaka are employees of Eli Lilly and Company and hold company stocks. Drs Palacios, Miazgowski, and Patrick were study investigators and received funding from Eli Lilly and Company, Indianapolis, Indiana. These external authors had access to the data relevant to this manuscript.
Funding Information:
Partly pharmaceutical: Odense University Hospital The work behind this study was supported by unrestricted grants from H. Lundbeck A/S and Gruenenthal GmbH and a grant from the Danish Clinical Intervention Research Academy.
Funding Information:
Non-pharmaceutical: "We thank the Apicil foundation for their financial support"
Funding Information:
Non-pharmaceutical: "This work was supported by theNational Health and Medical Research Council(NHMRC, Australia, ID 1024401). Drs Urquhart, Wluka, and Wang are recipients of NHMRC Career Development Fellowships (Clinical Level 1 No.1011975; Clinical Level 2 No. 1063574; Clinical Level1 No. 1065464, respectively)"
Funding Information:
Pharmaceutical: sponsored by Wyeth, company now owned by Pfizer
Funding Information:
Dr Clauw has received grant support from Cypress Bioscience, Inc., and serves as a consultant to Cypress Bioscience, Forest Laboratories, and Pierre Fabre Medicament, all of which are involved in the development of milnacipran for fibromyalgia. He also acts as a consultant to Eli Lilly and Company, Pfizer Inc., Procter & Gamble, and Wyeth Pharmaceuticals. He has owned stock in Cypress Bioscience. Dr Mease has received research grant support from Allergan, Inc.; Cypress Bioscience; Forest Laboratories; Fralex Therapeutics Inc.; Jazz Pharmaceuticals; Eli Lilly; Pfizer; and Wyeth. Drs Palmer and Wang are employees of Forest Research Institute and own stock in Forest Laboratories. Dr Gendreau is an employee of Cypress Bioscience and owns stock in that company.
Funding Information:
Non-pharmaceutical: funded by Helsinki University Central Hospital Research Fund
Funding Information:
Non-pharmaceutical: This study was supported by grant CA31946 from the NCI Division of Cancer Prevention, the Alliance Statistics and Data Center, and the Alliance Chairman
Funding Information:
Drs Chappell, Detke, Kajdasz, Walker, and Wohlreich are employees and stockholders of Eli Lilly and Company. Drs Arnold, Mease, Russell, and Smith were Principal Investigators at sites conducting the trial. Their sites received funds for participating in the research study. Dr Arnold has received grants/research support from Eli Lilly and Company, Pfizer Inc, Cypress Biosciences Inc, Wyeth Pharmaceuticals, Sanofi-Aventis, Boehringer Ingelheim, Allergan, and Forest; she has been a consultant for Eli Lilly and Company, Pfizer Inc, Cypress Biosciences Inc, Wyeth Pharmaceuticals, Sanofi-Aventis, Boehringer In-gelheim, Sepracor, Forest Laboratories Inc, Allergan, Vivus Inc, and Organon; and she is on the Speakers Bureau of Eli Lilly and Company and Pfizer, Inc. Dr Mease has received grants/research support from Eli Lilly and Company, Pfizer Inc, Cypress Bioscience, Forest, Allergan, Fralex, and Boehringer Ingel-heim; he has been a consultant for Eli Lilly and Company, Pfizer Inc, Cypress Bioscience, Forest, Allergan, Fralex, Boehringer Ingelheim, Pierre Fabre, and Wyeth; and he is on the Speakers Bureau of Pfizer Inc. Dr Russell has received grants/research support from the National Institutes of Health, RGK Foundation of Austin Texas, The National Fibromyalgia Association, Autoimmune Technologies, LLC, New Orleans, Louisiana, LKB World (Southern France), Pfizer Central Research, Eli Lilly and Company, Orphan Medical/Jazz, Grutnenthal GmbH, Allergan, and Schwarz; and he is on medical advisory boards of Pfizer Inc, Eli Lilly and Company, Jazz Pharmaceutical, Gruenthal GmbH, and Allergan. Dr Smith has received grants/research support from Abbott, Allergan, AstraZeneca, Bristol-Myers Squibb, Eli Lilly and Company, GlaxoSmithKline, Johnson and Johnson, Merck, Ortho-McNeil, Pfizer Inc, Minster, Novartis, Novo Nordisk, Orexigen, Shionogi, Schwarz, Vernalis, and Wyeth; he has been a consultant or on advisory boards of Allergan, Eli Lilly and Company, was previously on a medical advisory board for Eli Lilly and Compant, GlaxoSmithKline and Merck.
Funding Information:
Non-pharmaceutical: "This work was funded in part by Fayoum University Hospitals (Fayoum, Egypt) and by the authors’ personal resources."
Funding Information:
Non-pharmaceutical: this work was supported by the National Health and Medical Research Council of Australia (Dr Talley, PI).
Funding Information:
Non-pharmacetucal: financial support was received from the Helsinki University Central Hospital Research Funds.
Funding Information:
Non-pharamaceutical: supported by grant RO-1 HD040123-05 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
Funding Information:
Non-pharmaceutical: "We are thankful to the Vice Chancellor of Mashhad University of Medical Sciences for providing financial support for this study".
Funding Information:
Non-pharmaceutical: supported by a research grant from the National Institutes of Health (RO1-DK49334).
Funding Information:
Pharmaceutical: The study was sponsored by Forest Laboratories Inc. in collaboration with Cypress Bioscience Inc. (acquired by Royalty Pharma).
Funding Information:
Part funded by pharmaceutical: "This work was supported by a Forest Laboratories Investigator-initiated grant to B.H.N., and, in part, by National Institutes of Mental Health (NIMH) grant R01 MH100005 to D.C.S."
Funding Information:
Partly pharmaceutical: Eli Lilly Pharmaceuticals (IIT number: F1J-US-XO61). This research was also partially supported by grants from National Institute of Neurological Disorders and Stroke, ninds.nih.gov (NS035115), and National Center for Complementary and Integrative Health, nccih.nih.gov (AT007987) of the US National Institutes of Health. PT was supported by postdoctoral fellowships from the Canadian Institutes of Health Research (CIHR), cihr-irsc.gc.ca.
Funding Information:
Dr Robinson was a full-time employee and shareholder of Eli Lilly and Company at the time this study was conducted. Dr Robinson is a current employee of AbbVie. Author TLV is a consultant and/or advisory board member with Lilly and has received grants from and is involved in research supported by Lilly. Authors RCR and SKM are current employees and/or stockholders of Lilly.
Funding Information:
Non-pharmaceutical: This work was supported by grants from The Medical Research Council, project no. 9058, The Swedish Association of Neurologically Disabled, The County Council of Ostergotland, and The University Hospital of Linkoping
Funding Information:
Partly pharmaceutical - supported by grants from the Canadian Arthritis Society and Merck Frosst Canada
Funding Information:
Pharmaceutical: research for this study was funded by Eli Lilly and Company
Funding Information:
Non-pharmaceutical: "This study was supported by Tehran University of Medical Sciences (TUMS) through a grant to Prof. Shahin Akhondzadeh (Grant number 31842)."
Funding Information:
At the time this study was conducted, Professor Stein, Professor Seedat and Dr Muller were funded by the Medical Research Council of South Africa
Funding Information:
Pharmaceutical: "This study was supported by Forest Laboratories through an Investigator-Initiated Award." "Dr Marks has served as a consultant to Forest, Dey, Gilead, and TTK; has received grant/research support from Bristol-Myers Squibb, Dov, Eli Lilly, Endo, GlaxoSmithKline, Janssen, Johnson & Johnson, Pfizer, Saegis, Sepracor, and Somaxon; and has served on the speakers or advisory boards of Alkermes, Bristol-Myers Squibb, Dey, Pfizer, and Sunovion.
Funding Information:
Non-pharmaceutical: supported by grants from the Rheumatism Research Foundation
Funding Information:
Non-pharmaceutical: this study was supported by the Medical Scientific Fund of the Mayor of the City of Vienna, Vienna, Austria
Funding Information:
Non-pharmaceutical: "This study was supported by the Council of Research of the Saint Joseph University of Beirut – Lebanon (FM201)"
Funding Information:
Non-pharmaceutical: supported by the Danish National Research Council (NASTRA grant no. 42820) and the local research foundation at Odense University Hospital.
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