The Use of Antidepressants in the Long-Term Treatment Should not Improve the Impact of Fibromyalgia on Quality of Life

Abstract

Background:Antidepressant (AD) drugs are effective in the short term treatment of fibromyalgia (FM). It may be useful to study the long-term impact of AD on patients with FM.Methods:One-year follow-up study on 23 females with FM divided into groups on AD (ADg-N=7), and not taking AD (NADg-N=11). Evaluation at t1 and at the end (t2) with the Fibromyalgia Impact Questionnaire (FIQ); at t2 with: SCID-IV; Mood Disorder Questionnaire (MDQ); Short Form-12; Hamilton Depression Rating Scale (HAM-D); Functioning Assessment Short Test (FAST)Results:After a year the AD group showed a worst impact of the disease by FIQ (p=0.017), worsened quality of life by SF-12 (p<0.01), and disability linked to bipolar symptoms by FAST (p=0.05). About 40% of the sample was screened positive at MDQ without difference in the two groups. The patients who recovered from a depressive episode did not differ between ADg and NADg (20% vs 33.3%), and were fewer than expected from the literature (40-60%). The HAM-D score at the end of the trial was worse in the ADg (p<0.03).Limitations:Observational research on few patients, not specifically designed to test the hypothesis. The results have a heuristic value only.Discussion:The results should be read in the light of the high prevalence of patients screened positive for Bipolar Disorders and of the well-known poor response of the mood symptoms to antidepressants in Bipolar Depression. The deterioration in the long-term management of FM patients following AD treatments suggests the need for new and robust studies.

A preliminary study on serum proteomics in fibromyalgia syndrome

“…No patients suffered of thyroid dysfunction. Psychiatric examination data of patients were reported in a previous study [7].Study was approved from our Local Ethical Committee and informed consent was obtained from all subjects.Serum protein concentrations were quantified using the PlusOne 2D Quant Kit (GE Healthcare); first dimension isoelectric focusing (IEF) was carried out with 18 cm immobilized pH gradient strips of pH 3-10. The IPG strips were applied onto 10% acrylamide sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) slab gels (25.5 cm × 20.5 cm × 1.0 mm) and overlaid with a solution of 0.5% agarose with a trace of bromophenol blue.…”

“…No patients suffered of thyroid dysfunction. Psychiatric examination data of patients were reported in a previous study [7].…”

Fibromyalgia and Its Clinical Relevance in Renal Transplant Recipients

“…Based on the ACR 2010 preliminary classification criteria for FS, 99 RT recipients were studied to report the prevalence of FS in that population and to assess the possible links between FS and clinical, laboratory, and cardiovascular outcomes. Fibromyalgia is usually considered to be a disorder of women 20e50 years old; however, it also has been observed in men, children, adolescents, and older persons [13]. Recently, Yuceturk et al published a cohort study on FS in a sample of 122 HD patients [14].…”

Prevalence of fibromyalgia and co-morbid bipolar disorder: A systematic review and meta-analysis

“…Therefore, a significant number of patients may be suffering from FM with unmanaged BD, introducing a serious risk for suicide as a result of the agent selected to treat the pain syndrome. Further, the longterm efficacy and impact on quality of life of antidepressant for FM is currently being called into question (Carta et al, 2013;Hauser et al, 2013). One practical recommendation would be to select an agent such as gabapentin or pregabalin for the treatment of FM with symptoms consistent with BD.…”