The Use of Antidepressants in the Long-Term Treatment Should not Improve the Impact of Fibromyalgia on Quality of Life
MG Carta1, *, V Ruggiero2, F Sancassiani1, F Cutrano1, AR Manca1, M Peri3, A Fais4, E Cacace2
1 Dipartimento di Sanità Pubblica e Medicina Clinica e Sperimentale, Università di Cagliari e Center of Liaison
Psychiatry and Psychosomatics, University Hospital of Cagliari, Italy
2 Dipartimento di Scienze Mediche “Mario Aresu”- Universita’ degli Studi di Cagliari – 09042 Monserrato – Cagliari, Italy
3 Dipartimento di Scienze Chirurgiche - Universita’ degli Studi di Cagliari – 09042 Monserrato – Cagliari, Italy
4 Dipartimento di Scienze della Vita e dell’Ambiente, Università di Cagliari, 09042 Monserrato, Cagliari, Italy
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.
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)
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).
Observational research on few patients, not specifically designed to test the hypothesis. The results have a heuristic value only.
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.
Keywords: : Fibromyalgia, Antidepressants, Efficacy, Long-Term Treatment, Quality of life.
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