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Comment & Response
March 2019

Low-Dose Amitriptyline for Chronic Low Back Pain—Reply

Author Affiliations
  • 1Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIctoria, Australia
JAMA Intern Med. 2019;179(3):450-451. doi:10.1001/jamainternmed.2018.8145

In Reply We would like to thank Kalita and Misra for their response. They suggest that the use of an active comparator may negate the difference in adverse events of amitriptyline. However, we found that more than 30% of participants in both groups had moderate and/or severe symptoms at baseline, similar to the adverse events associated with psychotropic medications, and that the proportion with these symptoms did not increase, with no difference between groups at 6 months. Moreover, 12% of participants withdrew from our trial due to adverse events, which is similar to the number reported by other trials.1,2

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