3.47 +/À .67 3.37 +/À .79 3.29 +/À .82 3.40 +/À .74 physicians. While the extent and impact of alcohol-medication interactions require further study, these results suggest that potentially dangerous alcohol and medication interactions are common and unrecognized by primary care physicians. (1966 ± 2000) , PsycLit, Cinhal, Embase, Aidsline, Healthstar, Cancerlit, the Cochrane library (clinical trials registry and the Database of Systematic Reviews), Micromedex and FEDRIP as well as references of reviewed articles. Inclusion criteria included English-language, randomized, placebo-controlled trials of antidepressant medication among adults with back pain. Data were abstracted independently by two reviewers. Two continuous outcomes, back pain severity and ability to perform activities of daily living, were measured. Study quality was assessed using the methods of Jadad and data were synthesized using a random effects model. RESULTS: Ten trials were included, the majority of which studied tricyclic antidepressants (8/ 10 studies) in the setting of chronic back pain (7/10 studies). Patients treated with antidepressants were not more likely to improve than those treated with placebo either in pain severity (Standardized Mean Difference: (SMD) 0.14, 95%CI: À 0.27,0.55) or in activities of daily living (SMD: 0.77, 95% CI: À 0.07, 1.61). Patients receiving antidepressants experienced greater side effects (24% vs. 16%, p = 0.03) than those receiving placebo.