 |
 |
 |
 |
 |
 |
 |
|
|
|
|||||||||
|
|||||||||||
Associate Professor of Psychiatry, Karadeniz Technical University School of Medicine, Farabi Hospital, Trabzon, Turkey
Resident of Psychiatry, Karadeniz Technical University School of Medicine, Farabi Hospital
Associate Professor of Psychiatry, Karadeniz Technical University School of Medicine, Farabi Hospital
Professor of Physical Therapy and Rehabilitation, Karadeniz Technical University School of Medicine, Farabi Hospital
Reprints: Kemal Sayar MD, Karadeniz Technical University School of Medicine, Inonu Caddesi Sumko Sitesi, K 2 Blok, Daire: 11, 81090 Istanbul, Turkey, FAX 90 1 462 325 12 42, mkemalsayar{at}superonline.com or kemalsayar{at}hotmail.com
BACKGROUND: Although the pathophysiology of fibromyalgia is unknown, central monoaminergic transmission may play a role. Antidepressants have proved to be successful in alleviating symptoms of fibromyalgia. Medications that act on multiple neurotransmitters may be more effective in symptom management.
OBJECTIVE: To assess the efficacy of venlafaxine, a potent inhibitor of both norepinephrine and serotonin reuptake, in the treatment of patients with fibromyalgia.
METHODS: Fifteen patients with fibromyalgia were assessed prior to and after treatment with fixed-dose venlafaxine 75 mg/d. Before initiation of pharmacotherapy, patients were interviewed with the Structured Clinical Interview for Axis I disorders in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. The study lasted for 12 weeks, and patients were evaluated in weeks 6 and 12. The primary outcome measures were the Fibromyalgia Impact Questionnaire (FIQ) total score and pain score. The anxiety and depression levels of the patients were measured with the Beck Depression, the Beck Anxiety, the Hamilton Anxiety, and the Hamilton Depression scales.
RESULTS: There was a significant improvement in the mean intensity of pain (F = 14.3; p = 0.0001) and in the disability caused by fibromyalgia (F = 42.7; p = 0.0001) from baseline to week 12 of treatment. The depression and anxiety scores also decreased significantly from baseline to week 12. The improvement in the FIQ scores did not correlate with the decrease of scores in both patient- and physician-rated depression and anxiety inventories. Change in pain scores also was not correlated with the change in depression and anxiety scores.
CONCLUSIONS: Venlafaxine was quite promising in alleviating the pain and disability associated with fibromyalgia. This effect seems to be independent of its anxiolytic and antidepressant properties. Blockade of both norepinephrine and serotonin reuptake might be more effective than blockade of either neurotransmitter alone in the treatment of fibromyalgia.
Key Words: antidepressants, fibromyalgia, venlafaxine
Published Online, September 18, 2003. www.theannals.com, DOI 10.1345/aph.1D112
This article has been cited by other articles:
|
|
 |
|
  L. L. Krypel Fibromyalgia: A Review of Its Pathophysiology and Drug Treatment Journal of Pharmacy Practice, February 1, 2009; 22(1): 6 - 16. [Abstract] [PDF]
|
|
|
|
 |
|
 J. F. Karp and C. F. Reynolds III Depression, Pain, and Aging Focus, January 1, 2009; 7(1): 17 - 27. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Perrot, R.-M. Javier, M. Marty, C. Le Jeunne, F. Laroche, and the CEDR (Cercle d'Etude de la Douleur en Rhumatol Is there any evidence to support the use of anti-depressants in painful rheumatological conditions? Systematic review of pharmacological and clinical studies Rheumatology, August 1, 2008; 47(8): 1117 - 1123. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. C. Deecher, C. E. Beyer, G. Johnston, J. Bray, S. Shah, M. Abou-Gharbia, and T. H. Andree Desvenlafaxine Succinate: A New Serotonin and Norepinephrine Reuptake Inhibitor J. Pharmacol. Exp. Ther., August 1, 2006; 318(2): 657 - 665. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Goldenberg, C. Burckhardt, and L. Crofford Management of Fibromyalgia Syndrome JAMA, November 17, 2004; 292(19): 2388 - 2395. [Abstract] [Full Text] [PDF]
|
|
 |
 |
 |
 |
 |
 |
 |
