This report describes a double-blind between-group comparison of
Tofranil and placebo in fifty-nine patients admitted to the Joint Service Medical Rehabilitation Unit suffering from
low back pain. Patients were given 25 mg of either
Tofranil or placebo three times a day for four weeks. Fifteen patients were not included in the analysis, nine dropping out for non-trial related reasons, two dropping out complaining of lost libido and four not taking the
tablets, or taking additional drugs. One of the patients complaining of lost libido was taking
Tofranil and the other was taking placebo. Over the whole sample there was no significant benefit for
Tofranil over placebo as regards physical measurements. Both
Tofranil and placebo groups showed a significant improvement during the trial on straight leg raise and backward flexion. For lateral flexion the
Tofranil group was significantly worse than the placebo group on entering the trial, and during the trial the
Tofranil group improved to match the placebo group. The clinician's
pain and stiffness assessments and the patients'
pain and stiffness assessments show a significant improvement for both the
Tofranil and placebo groups during the trial. However, no difference is shown between
Tofranil and placebo. The psychological tests show no difference between
Tofranil and placebo and only a marinal improvenmet over initial condition. Further analysis according to initial diagnosis showed nothing conclusive. Numerically, the use of
Tofranil produced a marked improvement in
pain and stiffness in patients with 'disc lesion only' diagnoses, whereas placebo did not produce an improvement. However, this observation was far from reaching statistical significance. Side-effects were not severe for either
drug. Additional medication was rarely used.