A randomized controlled trial of citalopram in the treatment of fibromyalgia

Abstract

Amitriptyline and cyclobenzaprine have shown some efficacy in treatment of the generalised pain syndrome, fibromyalgia. The aim of this study was to examine the efficacy of antidepressant dosages of the serotonin re-uptake inhibitor citalopram in fibromyalgia. In a double-blind, placebo-controlled study 22 patients with fibromyalgia were randomized to treatment with citalopram for 4 weeks at a dosage of 20 mg a day while 21 received placebo. After 4 weeks the dosage was increased to 40 mg for a further 4 weeks if the subjects did not report a marked improvement. After the end of treatment (8 weeks) no changes were observed in self-assessment of symptoms, physician's global assessment, tender points, Beck depression score or voluntary muscle strength and no differences were observed between the groups. Citalopram showed no demonstrable effect on this group of pain patients. The strength of the study was sufficient to exclude an effect of citalopram of more than 1 steps of 10 on the categoric scales for pain, fatigue and general condition (95% confidence limit), which indicates that the sample size was sufficiently large.

Efficacy of Antidepressants as Analgesics: A Review

“…50,54,56,[97][98][99][100][101][102] Five studies comparing SSRIs with placebo have found them to be superior to placebo for relieving neuropathic pain. 50,[103][104][105][106] In fibromyalgia, fluoxetine (ES: 1.08) is reported to have greater analgesic activity than citalopram (ES: 0.45) and paroxetine (ES: 0.19).…”

A Comparison of Reboxetine and Amitryptilline in the Treatment of Fibromyalgia Syndrome with Co-morbid Depressive Symptoms: An Open-label Preliminary Study

“…The recent meta-analyses of antidepressant trials have shown that tricyclic antidepressants to be moderately effective in the treatment of patients with FM (7,15). Although the studies evaluating the effects of selective serotonin reuptake inhibitors (SSRIs) in the treatment of FM yielded inconsistent results, these medications are better tolerated than the tricyclic antidepressants (16,17).…”

Fibromyalgia Syndrome a Decade Later

“…Fluoxetine hydrochloride and amitriptyline were more effective than placebo in reducing FM symptoms, and the combination of both worked better than either alone. 37 In other reports, however, there was no beneficial effect of fluoxetine 106 or of a different serotonin reuptake inhibitor, citalopram, 107 or of tenoxicam and bromazepam. 108 Treatment with alprazolam combined with ibuprofen demonstrated modest improvement.…”