Anti-depressants and centrally active agents for fibromyalgia syndrome

Nishishinya, María Betina; Urrútia, Gerard; Mease, Philip J.; Rodríguez, Alexis; Lizardo, Ricardo J Riera; González, López; Darko, Godwin

doi:10.1002/14651858.cd006192

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…A review gives a global mean prevalence of 2.7% (range 0.4% to 9.3%), and a mean in the Americas of 3.1%, in Europe of 2.5% and in Asia of 1.7%. It is more common in women, with a female to male ratio of 3:1 (4.2%:1.4%) (Queiroz 2013). Estimates of prevalence in specific populations vary greatly, but have been reported as being as high as 9% in female textile workers in Turkey and 10% in metalworkers in Brazil (Queiroz 2013).…”

Section: Introductionmentioning

confidence: 99%

“…It is more common in women, with a female to male ratio of 3:1 (4.2%:1.4%) (Queiroz 2013). Estimates of prevalence in specific populations vary greatly, but have been reported as being as high as 9% in female textile workers in Turkey and 10% in metalworkers in Brazil (Queiroz 2013). The change in diagnostic criteria does not appear to have significantly affected estimates of prevalence (Wolfe 2013a).…”

Section: Introductionmentioning

confidence: 99%

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Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia

Welsch

Üçeyler

Klose

et al. 2018

Cochrane Database of Systematic Reviews

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Background Fibromyalgia is a clinically defined chronic condition of unknown etiology characterized by chronic widespread pain that often co‐exists with sleep disturbances, cognitive dysfunction and fatigue. People with fibromyalgia often report high disability levels and poor quality of life. Drug therapy, for example, with serotonin and noradrenaline reuptake inhibitors (SNRIs), focuses on reducing key symptoms and improving quality of life. This review updates and extends the 2013 version of this systematic review. Objectives To assess the efficacy, tolerability and safety of serotonin and noradrenaline reuptake inhibitors (SNRIs) compared with placebo or other active drug(s) in the treatment of fibromyalgia in adults. Search methods For this update we searched CENTRAL, MEDLINE, Embase, the US National Institutes of Health and the World Health Organization (WHO) International Clinical Trials Registry Platform for published and ongoing trials and examined the reference lists of reviewed articles, to 8 August 2017. Selection criteria We selected randomized, controlled trials of any formulation of SNRIs against placebo or any other active treatment of fibromyalgia in adults. Data collection and analysis Three review authors independently extracted data, examined study quality, and assessed risk of bias. For efficacy, we calculated the number needed to treat for an additional beneficial outcome (NNTB) for pain relief of 50% or greater and of 30% or greater, patient's global impression to be much or very much improved, dropout rates due to lack of efficacy, and the standardized mean differences (SMD) for fatigue, sleep problems, health‐related quality of life, mean pain intensity, depression, anxiety, disability, sexual function, cognitive disturbances and tenderness. For tolerability we calculated number needed to treat for an additional harmful outcome (NNTH) for withdrawals due to adverse events and for nausea, insomnia and somnolence as specific adverse events. For safety we calculated NNTH for serious adverse events. We undertook meta‐analysis using a random‐effects model. We assessed the evidence using GRADE and created a 'Summary of findings' table. Main results We added eight new studies with 1979 participants for a total of 18 included studies with 7903 participants. Seven studies investigated duloxetine and nine studies investigated milnacipran against placebo. One study compared desvenlafaxine with placebo and pregabalin. One study compared duloxetine with L‐carnitine. The majority of studies were at unclear or high risk of bias in three to five domains. The quality of evidence of all comparisons of desvenlafaxine, duloxetine and milnacipran versus placebo in studies with a parallel design was low due to concerns about publication bias and indirectness, and very low for serious adverse events due to concerns about...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia

Welsch

Üçeyler

Klose

et al. 2018

Cochrane Database of Systematic Reviews

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“…Les études pharmacologiques récentes [13] se sont focalisées sur l'inhibition de la recapture de la sérotonine et la norépinéphrine comme neurotransmetteurs des voies descendantes inhibitrices de la douleur [14,15], de même que les tricycliques. Des résultats prometteurs ont été rapportés aux traitements pharmacologiques liés à l'alpha 2 delta (sous-unités des récepteurs des canaux calciques, entraînant une baisse de l'afflux du calcium dans les terminaisons nerveuses et une réduction de la libération secondaire de neurotransmetteurs qui jouent un rôle dans la genèse de la douleur).…”

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A multidisciplinary approach to fibromyalgia (FM)

Bendaya

Breton

Gahlouz

2007

Lett Med Phys Readapt

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Ce travail se veut une mise au point sur la prise en charge de la fibromyalgie (FM). Après un bref rappel clinique, physiopathologique et des principes du traitement médicamenteux, une large place est réservée au traitement non médicamenteux. Le consensus qui se dégage à travers les études scientifiques est en faveur d'une approche multidisciplinaire, associant exercices physiques personnalisés de type aérobie, étirement musculaire et rééducation en milieu aquatique. L'éducation du patient et la thérapie cognitive et comportementale jouent un rôle fondamental dans la prise en charge. La promotion d'un comportement positif avec l'aide psychologique, le maintien dans la mesure du possible d'un statut actif sur le plan professionnel sont des gages d'une évolution favorable de cette affection.Mots clés : FM -Traitement médical -Traitement non médicamenteux -Traitement multidisciplinaireThérapie cognitive et comportementale A multidisciplinary approach to fibromyalgia (FM) Abstract: The goal of this investigation was to report on the current treatment guidelines for fibromyalgia (FM). After reviewing the FM clinical presentation, pathophysiology, and medical treatment guidelines, we focus extensively on non-drug therapies. Based on the results of various scientific studies, a consensus is developing in favour of a multidisciplinary approach that combines physiotherapy in an aquatic environment, personalized aerobic exercise and muscle stretching. Patient education and cognitive and behavioural therapies play a fundamental role in clinical management. Encouraging positive behaviour through psychological techniques and maintaining an active professional life to the greatest extent possible help ensure the favourable outcome of this disorder.

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“…It was published in 2006 (Nishishinya 2006) has been split into several systematic reviews that will be/have been published as: Anticonvulsants for fibromyalgia (bÜceyler 2013b)Monoamine oxidase inhibitors (MAOIs) for fibromyalgia syndrome (Tort 2012)Non-steroidal anti-inflammatory drugs (NSAIDs), analgesics and opioids for fibromyalgiaSedatives and hypnotic agents for fibromyalgiaSelective serotonin reuptake inhibitors (SSRIs) for fibromyalgiaSerotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome (Häuser 2013b)Tricyclic agents for fibromyalgia The ‘clinical relevant tables’ and the ’grading system’ due to be performed as mentioned in the original protocol have been superseded by the new guidelines for ’Summary of findings’ tables, and GRADE, and the new ’Risk of bias’ tool for Cochrane reviews. …”

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Selective serotonin reuptake inhibitors for fibromyalgia syndrome

Walitt

Urrútia

Nishishinya

et al. 2015

Cochrane Database of Systematic Reviews

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Background Fibromyalgia is a clinically well-defined chronic condition with a biopsychosocial aetiology. Fibromyalgia is characterized by chronic widespread musculoskeletal pain, sleep problems, cognitive dysfunction, and fatigue. Patients often report high disability levels and poor quality of life. Since there is no specific treatment that alters the pathogenesis of fibromyalgia, drug therapy focuses on pain reduction and improvement of other aversive symptoms. Objectives The objective was to assess the benefits and harms of selective serotonin reuptake inhibitors (SSRIs) in the treatment of fibromyalgia. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 5), MEDLINE (1966 to June 2014), EMBASE (1946 to June 2014), and the reference lists of reviewed articles. Selection criteria We selected all randomized, double-blind trials of SSRIs used for the treatment of fibromyalgia symptoms in adult participants. We considered the following SSRIs in this review: citalopram, fluoxetine, escitalopram, fluvoxamine, paroxetine, and sertraline. Data collection and analysis Three authors extracted the data of all included studies and assessed the risks of bias of the studies. We resolved discrepancies by discussion. Main results The quality of evidence was very low for each outcome. We downgraded the quality of evidence to very low due to concerns about risk of bias and studies with few participants. We included seven placebo-controlled studies, two with citalopram, three with fluoxetine and two with paroxetine, with a median study duration of eight weeks (4 to 16 weeks) and 383 participants, who were pooled together. All studies had one or more sources of potential major bias. There was a small (10%) difference in patients who reported a 30% pain reduction between SSRIs (56/172 (32.6%)) and placebo (39/171 (22.8%)) risk difference (RD) 0.10, 95% confidence interval (CI) 0.01 to 0.20; number needed to treat for an additional beneficial outcome (NNTB) 10, 95% CI 5 to 100; and in global improvement (proportion of patients who reported to be much or very much improved: 50/168 (29.8%) of patients with SSRIs and 26/162 (16.0%) of patients with placebo) RD 0.14, 95% CI 0.06 to 0.23; NNTB 7, 95% CI 4 to 17. SSRIs did not statistically, or clinically, significantly reduce fatigue: standard mean difference (SMD) −0.26, 95% CI −0.55 to 0.03; 7.0% absolute improvement on a 0 to 10 scale, 95% CI 14.6% relative improvement to 0.8% relative deterioration; nor sleep problems: SMD 0.03, 95 % CI −0.26 to 0.31; 0.8 % absolute deterioration on a 0 to 100 scale, 95% CI 8.3% relative deterioration to 6.9% relative improvement. SSRIs were superior to placebo in the reduction of depression: SMD −0.39, 95% CI −0.65 to −0.14; 7.6% absolute improvement on a 0 to 10 scale, 95% CI 2.7% to 13.8% relative improvement; NNTB 13, 95% CI 7 to 37. The dropout rate due to adverse events was not higher with SSRI use than with placebo use (23/146 (15.8%) of patients with SSRIs and 14/138 (10.1%) of pati...

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Anti-depressants and centrally active agents for fibromyalgia syndrome

Cited by 6 publications

References 13 publications

Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia

Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia

A multidisciplinary approach to fibromyalgia (FM)

Selective serotonin reuptake inhibitors for fibromyalgia syndrome

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