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Antidepressants in the treatment of fibromyalgia

Fibromyalgia syndrome is a chronic disease of widespread and debilitating pain whose cause is unknown and whose risk factors are poorly understood. It is often comorbid with rheumatoid and other pain disorders as well as psychiatric disorders such as anxiety and depression. Although they are not off...

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Detalles Bibliográficos
Autores principales: Moret, Chantal, Briley, Mike
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671948/
https://www.ncbi.nlm.nih.gov/pubmed/19412502
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author Moret, Chantal
Briley, Mike
author_facet Moret, Chantal
Briley, Mike
author_sort Moret, Chantal
collection PubMed
description Fibromyalgia syndrome is a chronic disease of widespread and debilitating pain whose cause is unknown and whose risk factors are poorly understood. It is often comorbid with rheumatoid and other pain disorders as well as psychiatric disorders such as anxiety and depression. Although they are not officially approved for this indication, antiepileptics and antidepressants are often used to treat fibromyalgia. The tricyclic antidepressants (TCAs), particularly amitriptyline, are among the most common treatment strategies. Because of the poor tolerability of the tricyclics, the newer antidepressants have been widely tested in fibromyalgia. The selective serotonin reuptake inhibitors (SSRIs) and the reversible monoamine oxidase inhibitors do not seem to be particularly helpful. The serotonin and norepinephrine reuptake inhibitors (SNRIs), duloxetine and milnacipran, on the other hand, have been shown in placebo-controlled trials to offer significant relief to patients suffering from fibromyalgia. Although no direct comparative studies have been performed, these compounds appear to be as effective as the TCAs but much better tolerated. The effectiveness of the SNRIs as well as other dual acting antidepressants, such as mirtazapine, but not the SSRIs, implies that a dysfunction of both serotonin and norepinephrine neurotransmission probably exists in fibromyalgia. The effectiveness of antidepressants appears to be independent of their effect on comorbid depression.
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spelling pubmed-26719482009-04-30 Antidepressants in the treatment of fibromyalgia Moret, Chantal Briley, Mike Neuropsychiatr Dis Treat Review Fibromyalgia syndrome is a chronic disease of widespread and debilitating pain whose cause is unknown and whose risk factors are poorly understood. It is often comorbid with rheumatoid and other pain disorders as well as psychiatric disorders such as anxiety and depression. Although they are not officially approved for this indication, antiepileptics and antidepressants are often used to treat fibromyalgia. The tricyclic antidepressants (TCAs), particularly amitriptyline, are among the most common treatment strategies. Because of the poor tolerability of the tricyclics, the newer antidepressants have been widely tested in fibromyalgia. The selective serotonin reuptake inhibitors (SSRIs) and the reversible monoamine oxidase inhibitors do not seem to be particularly helpful. The serotonin and norepinephrine reuptake inhibitors (SNRIs), duloxetine and milnacipran, on the other hand, have been shown in placebo-controlled trials to offer significant relief to patients suffering from fibromyalgia. Although no direct comparative studies have been performed, these compounds appear to be as effective as the TCAs but much better tolerated. The effectiveness of the SNRIs as well as other dual acting antidepressants, such as mirtazapine, but not the SSRIs, implies that a dysfunction of both serotonin and norepinephrine neurotransmission probably exists in fibromyalgia. The effectiveness of antidepressants appears to be independent of their effect on comorbid depression. Dove Medical Press 2006-12 /pmc/articles/PMC2671948/ /pubmed/19412502 Text en © 2006 Dove Medical Press Limited. All rights reserved
spellingShingle Review
Moret, Chantal
Briley, Mike
Antidepressants in the treatment of fibromyalgia
title Antidepressants in the treatment of fibromyalgia
title_full Antidepressants in the treatment of fibromyalgia
title_fullStr Antidepressants in the treatment of fibromyalgia
title_full_unstemmed Antidepressants in the treatment of fibromyalgia
title_short Antidepressants in the treatment of fibromyalgia
title_sort antidepressants in the treatment of fibromyalgia
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671948/
https://www.ncbi.nlm.nih.gov/pubmed/19412502
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