A Randomized Placebo-Controlled Trial of Sustained-Release Amitriptyline in Primary Fibromyalgia

Ginsberg, Francis; A, Mancaux; Joos, Erika; Vanhove, Philippe; Famaey, Jean Pierre

doi:10.1300/j094v04n03_05

Cited by 44 publications

(36 citation statements)

References 11 publications

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“…69 Fibromyalgia is another condition in which efficacy of TCAs is reasonably well-established. 55,[70][71][72][73][74][75][76][77][78][79][80][81][82][83][84] Most studies have reported that TCAs were effective at doses lower than those needed for the treatment of depression. 80,83 The analgesic effect size (ES) (difference between 2 means [antidepressant analgesic effectplacebo analgesic effect] divided by the pooled estimate standard deviation) of TCAs ranged from 0.23 to 1.34 in fibromyalgia.…”

Section: (Continued)mentioning

confidence: 99%

“…85 However, greater effect was seen on sleep disorders and fatigue than on pain, indicating that TCAs have only a moderate analgesic effect in fibromyalgia. 78,80,83 In low back pain (LBP), TCAs have been the most frequently-tested antidepressants and, according to the guidelines of the American Pain Society and American College of Physicians, TCAs are effective for pain relief in LBP. 86 Their analgesic effect has been reported to be similar to that of NSAIDs.…”

Section: (Continued)mentioning

confidence: 99%

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Efficacy of Antidepressants as Analgesics: A Review

Dharmshaktu¹,

Tayal²,

Kalra³

2012

The Journal of Clinical Pharma

279

189

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Persistent pain disorders are usually not adequately alleviated by nonsteroidal anti‐inflammatory drugs or other simple analgesics. Use of antidepressants as adjuvant therapy for the control of persistent pain is currently being practiced in disorders such as fibromyalgia, neuropathic pain, rheumatoid conditions, low back pain, and headache. This review describes the various mechanisms of analgesic activity of antidepressants along with their efficacy and tolerability profiles. Meta‐analyses and clinical studies of these agents were retrieved through the use of MEDLINE, Google scholar, and Cochrane databases. Antidepressants are effective in both neuropathic and non‐neuropathic pain and have diverse mechanisms independent of their antidepressant effects. Tricyclic antidepressants (amitryptiline, nortryptiline, desipramine) are effective compounds in the treatment of neuropathic pain, fibromyalgia, low back pain, and headaches. Studies are ongoing for the dual serotonin norepinephrine reuptake inhibitors (duloxetine, venlafaxine) in several persistent pain conditions and these may be recommended in neuropathic pain, migraines, and fibromyalgia. Evidence suggests that although the analgesic effects of selective serotonin reuptake inhibitors (fluoxetine, paroxetine, citalopram) are limited and inconsistent, yet they have a superior tolerability profile compared with tricyclic antidepressants.

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Section: (Continued)mentioning

confidence: 99%

Section: (Continued)mentioning

confidence: 99%

Efficacy of Antidepressants as Analgesics: A Review

Dharmshaktu¹,

Tayal²,

Kalra³

2012

The Journal of Clinical Pharma

279

189

View full text Add to dashboard Cite

show abstract

“…43,50,51 In the clinical assay by Munguía-Izquierdo and LegazArrese, 52 physical exercise in warm water, three times a week for 16 weeks, was effective in reducing the pain and intensity of fi bromyalgia. Additionally, adult women who had not 24 Ginsberg et al, 30 Goldenberg et al, 31 Hannonen et al 32 Fluoxetine hydrochloride (20-80 mg/day) Selective inhibition of the 5-HT** uptake and of the Na+-K+-dependent transporter, adenosine triphosphatase…”

Section: Physical Exercisesmentioning

confidence: 99%

Uso da terapia não farmacológica, medicina alternativa e complementar na fibromialgia

Braz¹,

Paula

Diniz³

et al. 2011

Rev. Bras. Reumatol.

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Fibromyalgia is a chronic painful syndrome that affects up to 5% of the world population. It is associated with sleep and mood disorders, fatigue, and functional disability. Its pathogenesis involves a disorder of the central modulation of pain, impairment of the descending inhibitory system, and hyperactivity of substance P. Because of the extensive symptomatology of patients with fi bromyalgia and its multifactorial pathogenesis, its ideal treatment requires a multidisciplinary approach including the association of pharmacological and non-pharmacological therapies. The pharmacological therapy currently recommended for the syndrome includes antidepressants, calcium-channel modulators, muscle relaxants, and analgesics. In most cases, the non-pharmacological treatment consists of patient education, supervised aerobic physical activity, and cognitive-behavioral therapy. However, many patients do not respond satisfactorily, or have side effects associated with the long-term use of drugs, in addition to reporting diffi culties in adhering to a therapy based on exercises and physical medicine. Thus, physicians and patients are increasingly interested in an alternative and complementary therapy for fi bromyalgia. This review approaches the different therapeutic modalities used in fi bromyalgia, emphasizing the evidence of non-pharmacological therapy and use of alternative and complementary medicine for these patients.

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“…A systematic review of the literature was conducted in February 2008 to identify all published randomised studies that had assessed the efficacy of these drugs in fibromyalgia patients. Twenty-one relevant studies were identified 11,12,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] . At time of the analysis, pivotal trials of milnacipran were not published and were therefore not included in the analysis.…”

Section: Efficacymentioning

confidence: 99%