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Clin Pract Epidemiol Ment Health. 2013 Jul 12;9:120-4. doi: 10.2174/1745017901309010120. eCollection 2013.

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

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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.

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.

KEYWORDS:

Antidepressants; Efficacy; Fibromyalgia; Long-Term Treatment; Quality of life.

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