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. 2007 Oct 17;2007(4):CD005454. doi: 10.1002/14651858.CD005454.pub2

Graff‐Radford 2000.

Methods Double blind placebo controlled parallel design, eight weeks
Randomisation method not stated
Inclusion criteria:
 duration of pain at least six months
Participants Postherpetic neuralgia of 33.4 (29.5) months. 50 participants (49 final number). Mean age 72.9 (10.1), 27 male and 22 female patients. Pain score VAS 55.22 (16.34) and MPQ 23.22 (13.23). Pain score per group: in amitriptyline VAS 55.9 (19.58) and MPQ 22.54 (13.95), in amitriptyline + fluphenazine VAS 47.6 (13.43) and MPQ 27.25 (17.71), in fluphenazine VAS 65.4 (10.87) and MPQ 21.75 (10.18), and in placebo group VAS 53.92 (17.05) and 
 MPQ 21.46 (10.89)
Interventions Amitriptyline dose escalation from 12.5 mg to 200 mg, or amitriptyline from 12.5 mg to 200 mg + fluphenazine from 1 mg to 3 mg, or fluphenazine from 1 mg to 3 mg, or active placebo (glycopyrrolate or cellulose) daily orally
Outcomes Pain patients reported, VAS and MPQ. Beck Depression Inventory (BDI)
Pain by VAS on amitriptyline 
 26.6 (SD 16.77), on amitriptyline + fluphenazine 35.41 (SD 24.53), on fluphenazine 53.9 (SD 27.79), on placebo 48.53 (SD 24.99)
Pain by MPQ on amitriptyline 
 17.36 (SD 10.92), on amitriptyline + fluphenazine 23.50 (SD 13.52), on fluphenazine 19.83 (SD 8.83), on placebo 17.83 (SD 13.94)
Depression by BDI on amitriptyline
 11.1 (SD 7.5), on amitriptyline + fluphenazine 7.2 (SD 6.03), on fluphenazine 14.2 (SD 6.5), on placebo 14.0 (SD 14.3). Fluphenazine made no difference either alone or enhancing amitriptyline
Notes Dropouts: 1/12 on amitriptyline (SE), 0/12 on amitriptyline + fluphenazine, 0/13 on fluphenazine, 0/13 on placebo
SE: one withdrawn on amitriptyline due to sedation
Results of other depression scales also available
QS = 4 (R1, DB2, W1)
Risk of bias
Bias Authors' judgement Support for judgement
Allocation concealment (selection bias) Unclear risk B ‐ Unclear