{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:46:37Z","timestamp":1792737997194,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Treatment of preoperative depression has been shown to reduce pain perception and disability after spine surgery, which encouraged utilizing antidepressants as a treatment for pain. Though opioid consumption after spine surgery has been well studied, few studies have investigated its association with medications such as antidepressants and gabapentinoids. Therefore, our study investigated the relationship between antidepressants, gabapentinoids and opioid consumption after lumbar fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>After Institutional Review Board (IRB) approval, patients undergoing elective lumbar fusion from 2017 to 2021 at a single, academic, tertiary care center were identified. Patients were determined to be taking an antidepressant or gabapentinoid if they had these medications listed as active in their preoperative and first postoperative appointments. Opioid consumption before and after surgery was collected through the state Prescription Drug Monitoring Program (PDMP). Statistics were performed to compare patients across groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      411 patients were identified that underwent elective lumbar fusion with complete patient-reported outcomes and PDMP data. On multivariable analysis, preoperative morphine milligram equivalents (MMEs) were an independent predictor of postoperative MME\/day at all postoperative time points. Perioperative SNRI use was predictive of increased 90\u2013180\u00a0day MME\/day (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Perioperative gabapentinoid use was predictive of increased MME\/day at 30\u201390 days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034) and 180\u2013365 days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A complex relationship exists between the medical management of mood disorders and neuropathic pain using antidepressants, anxiolytics, and gabapentinoids for patients undergoing spinal surgery. Patients prescribed gabapentinoids and SNRIs are at increased risk of opioid use postoperatively while patients taking SSRIs do not demonstrate such increased risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-025-08764-6","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:30:45Z","timestamp":1744849845000},"page":"2445-2452","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Serotonin-norepinephrine reuptake inhibitor and gabapentinoid use independently predict greater postoperative opioid consumption in lumbar fusion patients"],"prefix":"10.1007","volume":"34","author":[{"given":"Rajkishen","family":"Narayanan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Dalton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"A. McCurdy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Z. Issa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Oris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Tomlak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunsoo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"McCall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dodger","family":"Norceide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Mangan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"F. Kurd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian David","family":"Kaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Canseco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan S.","family":"Hilibrand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Vaccaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Kepler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Schroeder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"8764_CR1","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/S0140-6736(21)02252-2","volume":"399","author":"K Humphreys","year":"2022","unstructured":"Humphreys K, Shover CL, Andrews CM et al (2022) Responding to the opioid crisis in North America and beyond: recommendations of the Stanford-Lancet commission. Lancet 399:555\u2013604. https:\/\/doi.org\/10.1016\/S0140-6736(21)02252-2","journal-title":"Lancet"},{"key":"8764_CR2","doi-asserted-by":"crossref","unstructured":"Hedegaard H, Spencer MR (2021) Urban-Rural Differences in Drug Overdose Death Rates, 1999\u20132019. NCHS Data Brief 1\u20138","DOI":"10.15620\/cdc:102891"},{"key":"8764_CR3","doi-asserted-by":"publisher","first-page":"202","DOI":"10.15585\/mmwr.mm7006a4","volume":"70","author":"CL Mattson","year":"2021","unstructured":"Mattson CL, Tanz LJ, Quinn K et al (2021) Trends and geographic patterns in drug and synthetic opioid overdose Deaths - United States, 2013\u20132019. MMWR Morb Mortal Wkly Rep 70:202\u2013207. https:\/\/doi.org\/10.15585\/mmwr.mm7006a4","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"8764_CR4","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1016\/j.spinee.2018.12.014","volume":"19","author":"ER Oleisky","year":"2019","unstructured":"Oleisky ER, Pennings JS, Hills J et al (2019) Comparing different chronic preoperative opioid use definitions on outcomes after spine surgery. Spine J 19:984\u2013994. https:\/\/doi.org\/10.1016\/j.spinee.2018.12.014","journal-title":"Spine J"},{"key":"8764_CR5","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1097\/BRS.0000000000002964","volume":"44","author":"JM Hills","year":"2019","unstructured":"Hills JM, Pennings JS, Archer KR et al (2019) Preoperative opioids and 1-year Patient-reported outcomes after spine surgery. Spine (Phila Pa 1976) 44:887\u2013895. https:\/\/doi.org\/10.1097\/BRS.0000000000002964","journal-title":"Spine (Phila Pa 1976)"},{"key":"8764_CR6","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.wneu.2021.12.086","volume":"159","author":"S Mohan","year":"2022","unstructured":"Mohan S, Lynch CP, Cha EDK et al (2022) Baseline risk factors for prolonged opioid use following spine surgery: systematic review and Meta-Analysis. World Neurosurg 159:179\u2013188e2. https:\/\/doi.org\/10.1016\/j.wneu.2021.12.086","journal-title":"World Neurosurg"},{"key":"8764_CR7","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1038\/sc.2008.115","volume":"47","author":"A Craig","year":"2009","unstructured":"Craig A, Tran Y, Middleton J (2009) Psychological morbidity and spinal cord injury: a systematic review. Spinal Cord 47:108\u2013114. https:\/\/doi.org\/10.1038\/sc.2008.115","journal-title":"Spinal Cord"},{"key":"8764_CR8","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.wneu.2015.11.067","volume":"87","author":"AA Elsamadicy","year":"2016","unstructured":"Elsamadicy AA, Adogwa O, Cheng J, Bagley C (2016) Pretreatment of depression before cervical spine surgery improves patients\u2019 perception of postoperative health status: A retrospective, single institutional experience. World Neurosurg 87:214\u2013219. https:\/\/doi.org\/10.1016\/j.wneu.2015.11.067","journal-title":"World Neurosurg"},{"key":"8764_CR9","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.31616\/asj.2018.0237","volume":"13","author":"AB Bayoumi","year":"2019","unstructured":"Bayoumi AB, Ikizgul O, Karaali CN et al (2019) Antidepressants in spine surgery: A systematic review to determine benefits and risks. Asian Spine J 13:1036\u20131046. https:\/\/doi.org\/10.31616\/asj.2018.0237","journal-title":"Asian Spine J"},{"key":"8764_CR10","doi-asserted-by":"publisher","first-page":"CD014682","DOI":"10.1002\/14651858.CD014682.pub2","volume":"5","author":"H Birkinshaw","year":"2023","unstructured":"Birkinshaw H, Friedrich CM, Cole P et al (2023) Antidepressants for pain management in adults with chronic pain: a network meta-analysis. Cochrane Database Syst Rev 5:CD014682. https:\/\/doi.org\/10.1002\/14651858.CD014682.pub2","journal-title":"Cochrane Database Syst Rev"},{"key":"8764_CR11","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.3171\/2015.10.JNS151516","volume":"125","author":"N Shimony","year":"2016","unstructured":"Shimony N, Amit U, Minz B et al (2016) Perioperative Pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study. J Neurosurg 125:1513\u20131522. https:\/\/doi.org\/10.3171\/2015.10.JNS151516","journal-title":"J Neurosurg"},{"key":"8764_CR12","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1093\/pm\/pnad045","volume":"24","author":"A Azimi","year":"2023","unstructured":"Azimi A, Hooshmand E, Mafi AA, Tabatabaei F-S (2023) Effect of Duloxetine on opioid consumption and pain after total knee and hip arthroplasty: a systematic review and meta-analysis of randomized clinical trials. Pain Med 24:1035\u20131045. https:\/\/doi.org\/10.1093\/pm\/pnad045","journal-title":"Pain Med"},{"key":"8764_CR13","doi-asserted-by":"publisher","first-page":"153","DOI":"10.3171\/2014.4.SPINE12668","volume":"21","author":"O Adogwa","year":"2014","unstructured":"Adogwa O, Verla T, Thompson P et al (2014) Affective disorders influence clinical outcomes after revision lumbar surgery in elderly patients with symptomatic adjacent-segment disease, recurrent stenosis, or pseudarthrosis: clinical Article. J Neurosurg Spine 21:153\u2013159. https:\/\/doi.org\/10.3171\/2014.4.SPINE12668","journal-title":"J Neurosurg Spine"},{"key":"8764_CR14","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.spinee.2013.01.017","volume":"13","author":"O Adogwa","year":"2013","unstructured":"Adogwa O, Parker SL, Shau DN et al (2013) Preoperative Zung depression scale predicts patient satisfaction independent of the extent of improvement after revision lumbar surgery. Spine J 13:501\u2013506. https:\/\/doi.org\/10.1016\/j.spinee.2013.01.017","journal-title":"Spine J"},{"key":"8764_CR15","doi-asserted-by":"publisher","first-page":"2392","DOI":"10.1016\/j.spinee.2014.01.047","volume":"14","author":"M Pakarinen","year":"2014","unstructured":"Pakarinen M, Vanhanen S, Sinikallio S et al (2014) Depressive burden is associated with a poorer surgical outcome among lumbar spinal stenosis patients: a 5-year follow-up study. Spine J 14:2392\u20132396. https:\/\/doi.org\/10.1016\/j.spinee.2014.01.047","journal-title":"Spine J"},{"key":"8764_CR16","doi-asserted-by":"publisher","first-page":"E5","DOI":"10.3171\/2017.10.FOCUS17563","volume":"44","author":"C O\u2019Connell","year":"2018","unstructured":"O\u2019Connell C, Azad TD, Mittal V et al (2018) Preoperative depression, lumbar fusion, and opioid use: an assessment of postoperative prescription, quality, and economic outcomes. NeuroSurg Focus 44:E5. https:\/\/doi.org\/10.3171\/2017.10.FOCUS17563","journal-title":"NeuroSurg Focus"},{"key":"8764_CR17","doi-asserted-by":"publisher","first-page":"260","DOI":"10.5435\/JAAOS-D-16-00049","volume":"25","author":"MF Kurd","year":"2017","unstructured":"Kurd MF, Kreitz T, Schroeder G, Vaccaro AR (2017) The role of multimodal analgesia in spine surgery. J Am Acad Orthop Surg 25:260\u2013268. https:\/\/doi.org\/10.5435\/JAAOS-D-16-00049","journal-title":"J Am Acad Orthop Surg"},{"key":"8764_CR18","doi-asserted-by":"publisher","first-page":"e2328121","DOI":"10.1001\/jamanetworkopen.2023.28121","volume":"6","author":"SHL Tsai","year":"2023","unstructured":"Tsai SHL, Hu C-W, El Sammak S et al (2023) Different Gabapentin and Pregabalin dosages for perioperative pain control in patients undergoing spine surgery: A systematic review and network Meta-Analysis. JAMA Netw Open 6:e2328121. https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.28121","journal-title":"JAMA Netw Open"},{"key":"8764_CR19","doi-asserted-by":"publisher","first-page":"105624","DOI":"10.1016\/j.jbspin.2023.105624","volume":"91","author":"B G\u00e9rard","year":"2024","unstructured":"G\u00e9rard B, Bailly F, Trouvin A-P (2024) How to treat chronic pain in rheumatic and musculoskeletal diseases (RMDs) - A Pharmacological review. Joint Bone Spine 91:105624. https:\/\/doi.org\/10.1016\/j.jbspin.2023.105624","journal-title":"Joint Bone Spine"},{"key":"8764_CR20","doi-asserted-by":"publisher","first-page":"E375","DOI":"10.1097\/BSD.0000000000001465","volume":"36","author":"MJ Lambrechts","year":"2023","unstructured":"Lambrechts MJ, Toci GR, Fried TB et al (2023) Preoperative opioid prescribers and lumbar fusion: their effect on clinical outcomes and postoperative opioid usage. Clin Spine Surg 36:E375. https:\/\/doi.org\/10.1097\/BSD.0000000000001465","journal-title":"Clin Spine Surg"},{"key":"8764_CR21","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1016\/j.spinee.2019.12.019","volume":"20","author":"AV Karhade","year":"2020","unstructured":"Karhade AV, Cha TD, Fogel HA et al (2020) Predicting prolonged opioid prescriptions in opioid-na\u00efve lumbar spine surgery patients. Spine J 20:888\u2013895. https:\/\/doi.org\/10.1016\/j.spinee.2019.12.019","journal-title":"Spine J"},{"key":"8764_CR22","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1177\/0706743716659417","volume":"61","author":"SH Kennedy","year":"2016","unstructured":"Kennedy SH, Lam RW, McIntyre RS et al (2016) Canadian network for mood and anxiety treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder. Can J Psychiatry 61:540\u2013560. https:\/\/doi.org\/10.1177\/0706743716659417","journal-title":"Can J Psychiatry"},{"key":"8764_CR23","doi-asserted-by":"publisher","first-page":"S34","DOI":"10.4103\/0019-5545.196973","volume":"59","author":"S Gautam","year":"2017","unstructured":"Gautam S, Jain A, Gautam M et al (2017) Clinical practice guidelines for the management of depression. Indian J Psychiatry 59:S34\u2013S50. https:\/\/doi.org\/10.4103\/0019-5545.196973","journal-title":"Indian J Psychiatry"},{"key":"8764_CR24","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/j.jocn.2009.09.011","volume":"17","author":"MS Walid","year":"2010","unstructured":"Walid MS, Zaytseva NV (2010) Prevalence of mood-altering and opioid medication use among spine surgery candidates and relationship with hospital cost. J Clin Neurosci 17:597\u2013600. https:\/\/doi.org\/10.1016\/j.jocn.2009.09.011","journal-title":"J Clin Neurosci"},{"key":"8764_CR25","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1001\/jamainternmed.2016.3298","volume":"176","author":"EC Sun","year":"2016","unstructured":"Sun EC, Darnall BD, Baker LC, Mackey S (2016) Incidence of and risk factors for chronic opioid use among opioid-Naive patients in the postoperative period. JAMA Intern Med 176:1286\u20131293. https:\/\/doi.org\/10.1001\/jamainternmed.2016.3298","journal-title":"JAMA Intern Med"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-08764-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-025-08764-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-08764-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T07:32:56Z","timestamp":1751355176000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-025-08764-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,17]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["8764"],"URL":"https:\/\/doi.org\/10.1007\/s00586-025-08764-6","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,17]]},"assertion":[{"value":"4 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 November 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no potential conflict of interest to disclose relevant to the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}