Effect of duloxetine in temporomandibular joint disorders: A comparison with arthrocentesis

PURPOSE: This study was conducted to compare the efficacy of temporomandibular joint (TMJ) arthrocentesis, duloxetine therapy alone, and duloxetine in combination with TMJ arthrocentesis in the treatment of painful TMJ. MATERIALS AND METHODS: Thirty patients with TMJ pain were included in the study who were divided into three groups with ten patients in each group. Group A included patients having only TMJ arthrocentesis; in Group B, only duloxetine therapy (30 mg) was given twice a day orally for 3 months; and in Group C, a combination of TMJ arthrocentesis with duloxetine therapy (30 mg) was given twice a day orally for 3 months. Patients were followed at regular interval of the 1(st) day, 5(th) day, 7(th) day, 4(th) week, 6(th) week, and 12(th) week and assessed in terms of pain, maximum mouth opening (mm), clicking, Hospital Anxiety and Depression Rating Scale and estimation of interleukin-6 (IL-6). The data collected were compiled and statistically analyzed. RESULTS: The pain was found to be significantly lower in Group C than other groups at weeks 4, 6, and 12. In Group C, mouth opening increased significantly than Groups A and B on subsequent follow-ups. On biochemical analysis of IL-6 levels in lavage fluid, a significant decrease was observed in levels of IL-6 in lavage fluid in Groups A and C postoperatively. CONCLUSION: The present study states that pain was observed to be much less after arthrocentesis along with duloxetine therapy. This combination therapy leads to much better and faster outcome, but still, long-term follow-ups with larger number of patients are required.