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Patients aged 75 years and older saw better pain relief and improved quality of life compared with patients younger than 55 years.
In 11 comparisons, antidepressants were efficacious, but they were inefficacious or evidence was inconclusive for 31 comparisons.
However, those with persistent pain were no more likely to experience cognitive decline.
When patients do not experience meaningful improvement with the initial therapeutic class, medication from a different class should be offered.
Global assessments at six and 24 hours were better with NSAID use, and there were fewer adverse effects, including bleeding events.